Value-Based Contracting
Expert articles and analysis related to value-based contracting.
AI Summary — Last 30 Days
CMS is pushing value-based contracting further into chronic disease and drug-spend management: the ACCESS Model expansion adds heart failure, COPD, substance use disorder, and tobacco-use tracks beginning in 2027, signaling a longer-term CMMI strategy to pair digital care infrastructure with condition-specific accountability for Medicare providers (HFMA). At the same time, CMS finalized the GLOBE drug pricing model to test most-favored-nation-style pricing for Part B drugs, creating a new cost-control frontier that will affect provider economics, specialty care contracting, and payer-provider risk arrangements (Fierce Healthcare). The broader environment is becoming less forgiving for Medicare Advantage and risk-bearing entities, with RADV scrutiny, Star Ratings pressure, and MedPAC’s overpayment debate intensifying the tension between coding-driven revenue strategies and demonstrable performance on cost, quality, and population health.
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