Payment & Delivery Reform
Expert articles and analysis related to payment & delivery reform.
AI Summary — Last 7 Days
Synthesis: In the last week, value-based care stakeholders observed continued momentum for data-driven payment models, as CMS emphasized the necessity of robust data management infrastructure to underpin value-based contracts, highlighting operational challenges for health systems and payers shifting away from fee-for-service. Meanwhile, new evidence from Maryland’s global budget initiative demonstrated that hospital utilization fell by 11 percentage points more than in other states between 2013 and 2023, reinforcing the effectiveness of state-led, population-based payment reform and increasing pressure for broader national application of such models (Maryland global budgets impact). As CMS continues to review payment adequacy and updates for skilled nursing and physician services in the lead-up to potential 2027 rulemaking under the Trump administration, key tensions remain around ensuring advanced alternative payment models sustain provider viability without undermining access (Healthcare IT News—sound data management).
Related Articles
Under Global Budgets, Hospital Utilization In Maryland Decreased By 11 Percentage Points More Than In Other States, 2013–23
Under Global Budgets, Hospital Utilization In Maryland Decreased By 11 Percentage Points More Than In Other States, 2013–23  Health Affairs
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7th and possibly final update on the $39.94 lab test bill
By MATTHEW HOLT I know you all care, so I am giving a 7th update on the telenovela about my Labcorp bill for $34.95. The very TL:DR summary of where we are so farContinue reading...
Value-based contracts depend on sound data management
LT-CMS-2027MPFSRecommendations - American Academy of Family Physicians | AAFP
LT-CMS-2027MPFSRecommendations  American Academy of Family Physicians | AAFP
Assessing payment adequacy and updating payments: Skilled nursing facility services - MedPAC (.gov)
Assessing payment adequacy and updating payments: Skilled nursing facility services  MedPAC (.gov)
Illinois Court Allows Hospital’s Quantum Meruit Claim Against Insurer Despite No Contract
Radiology Question for the Week of April 13, 2026
What is the correct coding approach when iliac atherectomy and angioplasty and/or stent placement are performed in the same leg through the same access site?
General Question for the Week of April 13, 2026
When is modifier 25 applicable?
Cardiology Question for the Week of April 13, 2026
How does the Outpatient Prospective Payment System (OPPS) 2026 final rule impact cardiology?