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Value-Based Contracting

Expert articles and analysis related to value-based contracting.

191 articles•Last 30 Days

AI Summary — Last 30 Days

CMS is pushing value-based contracting toward larger, longer-duration, and more risk-bearing structures: CMMI’s new 10-year Long-term Enhanced ACO Design (LEAD) Model creates a strategic fork for ACOs considering participation by the May 17, 2026 deadline, while the FY 2027 IPPS proposal signals continued movement toward mandatory episodic payment through a redesigned, potentially nationwide CJR model. At the same time, CMS’s 2027 Medicare Advantage rate direction aims to narrow MA plans’ payment advantage, increasing pressure on payers and providers to prove risk-adjusted performance, specialty-care ROI, and population health infrastructure rather than relying on coding or benchmark arbitrage. For health systems, ACOs, and payer partners, the near-term positioning question is whether to scale accountable care capabilities across primary care, specialty models like kidney care, and episodes—before CMS and market contracts make downside-risk readiness less optional. LEAD Model overview | MA payment changes

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