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Payment Models

Expert articles and analysis related to payment models.

118 articlesLast 30 Days

AI Summary — Last 30 Days

CMS is accelerating a broader Trump administration shift toward scalable value-based payment: the new 10-year ACCESS model will launch July 5 with 150 participants, tying Medicare payments for technology-enabled chronic care in obesity, diabetes, musculoskeletal pain, and depression to measurable outcomes, while the LEAD ACO model aims to broaden accountable care participation for organizations not yet positioned for traditional MSSP downside risk. At the same time, CMS is moving in the opposite direction of purely voluntary experimentation by proposing a nationwide mandatory expansion of the joint replacement bundled payment model, signaling that CMMI’s payment-model portfolio is being repositioned around larger tests, chronic-condition accountability, technology enablement, and taxpayer-protection goals. For ACOs, health systems, and payers, the near-term strategic tension is whether to build capabilities for voluntary, tech-enabled population health models like ACCESS or prepare for broader mandatory episode-based risk such as the proposed CJR-X expansion.

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Broadening Accessibility To Accountable Care Via The Long-Term Enhanced ACO Design (LEAD) Model

Broadening Accessibility To Accountable Care Via The Long-Term Enhanced ACO Design (LEAD) Model  Health Affairs

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To LEAD or Not: Accountable Care Organizations have a decision to make by May 17

LEAD (the Long-term Enhanced ACO Design) Model is the Centers for Medicare & Medicaid Innovation Center’s newest accountable care organization (ACO) payment model, running for 10 years from January 1,...

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CMS Seeks to Expand Joint Replacement Care Model

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CMMI’s Advancing Chronic Care with Effective Scalable Solutions (ACCESS) Model Explained

In May 2025, CMS’s Center for Medicare & Medicaid Innovation (CMMI) unveiled it’s “Make America Healthy Again” vision. CMMI models focus on not only “protecting the federal taxpayer,” but also (i) pro...

Healthcare EconomistApr 28, 2026
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Around the nation: CMS halts BALANCE model after low payer participation

Around the nation: CMS halts BALANCE model after low payer participation  Advisory Board

Advisory BoardApr 23, 2026
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Innovaccer Positions Story Health in CMS ACCESS Value-Based Care Model

Innovaccer Positions Story Health in CMS ACCESS Value-Based Care Model  TipRanks

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CMS Proposes Nationwide Expansion of Comprehensive Care for Joint Replacement Model

CMS Proposes Nationwide Expansion of Comprehensive Care for Joint Replacement Model  Davis Wright Tremaine

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CMS delays Part D portion of BALANCE Model on expansion of GLP-1 access

CMS delays Part D portion of BALANCE Model on expansion of GLP-1 access  American Hospital Association

AHAApr 22, 2026
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Two providers say no to LEAD, showing there’s room to grow on LTC value-based care

Two providers say no to LEAD, showing there’s room to grow on LTC value-based care  McKnight's Long-Term Care News

McKnight's Long-Term Care NewsApr 20, 2026
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LEAD: Can CMS' new model expand value-based care?

LEAD: Can CMS' new model expand value-based care?  Advisory Board

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