Specialty & Bundled Payments
Expert articles and analysis related to specialty & bundled payments.
AI Summary — Last 30 Days
CMS is increasingly driving specialty and bundled-payment expansion as Medicare Advantage plans pull back, with TEAM and the proposed Ambulatory Specialty Model for heart failure pushing hospitals, specialists, and post-acute providers toward tighter longitudinal accountability for episodes, utilization, and outcomes. The strategic pressure point is operational: hospitals remain the accountable entity in models like CJR-X and TEAM, but surgeons, cardiologists, home health agencies, and high-value specialty networks increasingly determine performance—making care coordination, referral governance, and data infrastructure central to margin protection and VBC readiness. At the same time, the administrative cost burden of mandatory VBP programs is becoming a board-level issue, with new research estimating $3 billion in annual hospital costs, underscoring why readiness for models such as CJR-X and TEAM must pair payment strategy with workflow redesign and compliance automation.
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