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Value-Based Contracting

Expert articles and analysis related to value-based contracting.

200 articlesLast 30 Days

AI Summary — Last 30 Days

CMS is accelerating a structural pivot from legacy physician quality reporting toward accountable-care risk: proposed CY 2027 Medicare Physician Fee Schedule/MSSP changes would shift physician payment, phase out MIPS, and expand ACO participation, while LEAD applicants face near-term strategic choices between LEAD and MSSP as CMS finalizes participant lists and financial methodology. The operating tension is moving from “whether to take risk” to “which risk chassis to choose”—MSSP, LEAD, ACO REACH, or episode models such as CJR-X—with governance, coding accuracy, downside-risk mitigation, and home-based care partnerships becoming core capabilities rather than optional infrastructure. Early performance signals remain material: agilon reported its ACO REACH entities generated $229 million in gross savings and $54 million for the Medicare Trust Fund in 2024, reinforcing why CMS and market participants are pushing harder on scalable ACO models despite scrutiny over CMMI savings transparency and MA coding intensity (agilon ACO REACH results; Wakely on LEAD risk strategy).

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