Value-Based Contracting

CMS’s CY 2027 Medicare Physician Fee Schedule/MSSP proposal is accelerating a VBC pivot under the Trump administration: it would reshape physician payment, begin phasing out MIPS, and expand ACO participation—moves that drew support from Premier and ACP but also concern from physician groups over the proposed 2027 fee cut. The policy direction reinforces a broader shift from legacy quality reporting toward accountable-care and episode-based risk models, with stakeholders also parsing the emerging LEAD ACO model and the implications of ACO REACH savings as that model nears expiration. For ACOs, home-based care providers, and physician groups, the near-term strategic tension is whether new MSSP/ACO incentives and primary care supports are enough to offset lower fee-schedule economics and justify deeper risk-bearing partnerships ([Fierce Healthcare](https://news.google.com/rss/articles/CBMiywFBVV95cUxNT2dHa2MyVEVua1lDYWducm1nTVBZSl8weTJ3QU16czJ1TEVqMEMxT2ZJQU4xSjdRLXo2TEVDZzhJb3F6a2pHbzlMOXUzWFlFSGRSYjMyb0ZFcWZpSWlEZmpNTzVpVndtclh2T2Jhb2EyWllhVGRFc1RWZnlJYkhFQlh