Payment Model Reform

CMS is signaling that payment model reform under the Trump administration is moving toward tech-enabled chronic disease management and specialty/drug-cost accountability: the ACCESS Model expansion adds heart failure, COPD, substance use disorder, and tobacco cessation tracks beginning in 2027, positioning Medicare providers for more longitudinal, digitally supported care management across high-cost populations (Healthcare Dive). At the same time, CMS finalized the GLOBE drug pricing model to test most-favored-nation-style pricing in Part B, creating a parallel cost-control pressure point for health systems, specialty practices, ACOs, and MA stakeholders managing drug-intensive populations (Fierce Healthcare). The strategic tension is widening: CMS is pushing broader model participation and cross-payer alignment while providers face operational complexity, specialty-model attribution issues, and ongoing scrutiny of Medicare Advantage payment accuracy.