Total Cost Management
Expert articles and analysis related to total cost management.
AI Summary ā Last 24 Hours
CMSā FY 2027 hospital payment agenda is tightening the total-cost-management environment: inpatient hospitals face the new IPPS/LTCH final rule while outpatient departments and ASCs are looking at only a 2.4% proposed Medicare base update after productivity adjustments, raising margin pressure that will flow into ACO contracting, site-of-care strategy, and hospital-physician alignment (HFMA). At the same time, Medicaid community engagement/work requirements remain live after a judge declined to pause the rule, while AHA, AMGA, and MACPAC are pressing CMS for stronger safeguards against coverage lossesāan immediate population-health risk for providers managing Medicaid attributed lives and uncompensated-care exposure (Healthcare Dive). Medicare Advantage plans are also preparing 2027 market and network redesigns, signaling continued benefit/geography rationalization that could disrupt attribution, referral patterns, and payer mix for VBC organizations.
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