Policy & Regulatory Changes
Expert articles and analysis related to policy & regulatory changes.
AI Summary — Last 7 Days
CMS is signaling continued VBC expansion under the Trump administration through the CY 2027 PFS/MSSP proposals, with stakeholders parsing policies intended to grow accountable care relationships in Medicare while also preparing for mandatory episode-based payment via CJR-X and refinements to LEAD for long-term care alignment and financial methodology. At the same time, Medicare Advantage quality-payment volatility is intensifying as CMS appeals the Clover Health star ratings ruling and ACHP pushes CMS to use the higher of two MA Stars scores in 2027—raising stakes for MA plans, ACO-aligned providers, and payers dependent on benchmark, rebate, and quality bonus predictability. Medicaid policy risk also remains salient: KFF warns that new work requirements could disrupt coverage for SSI applicants navigating medical frailty exemptions, complicating population health management for high-need beneficiaries and safety-net VBC arrangements. [Aledade on CY 2027 PFS/MSSP](https://news.google.com/rss/articles/CBMitwFBVV95cUxQc21TWDBtNXJ2d3lzSlptTzZCMzM0bTMzTjY1TTRDM2FIVF9BYU5JWmdrSHg1Y0RCNmxRS293WHZWMGdtdkNUVVdpREJUTFZ0LVJOUDR1UlJlRWI5TXZkZ3VkU2c5cVNuR054T
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