Value-Based Contracting & VBC Models

Over the past month, CMS has accelerated the shift toward tech-enabled, outcomes-based payment models, with the launch of the ACCESS model representing a pivotal test of voluntary, lean-payment contracting for chronic disease management across more than 150 provider and digital health entities. At the same time, CMS has signaled a move toward greater mandatory risk with the proposed CJR-X nationwide bundled payment model for joint replacements, while long-term ACO evolution is taking shape via the newly unveiled LEAD model, which will lock base years, expand capitation, and increase specialist risk-sharing from 2027 onward. These moves clarify CMS’s intent to diversify VBC mechanisms—balancing broad voluntary innovation like ACCESS (Healthcare Finance) with mandatory programs (CJR-X) and structurally reengineered ACO models (Wakely)—forcing stakeholders to reassess risk appetite, partnerships, and technology integration strategies.