VBC Operations & Efficiency

Over the last 30 days, CMS under the Trump administration has accelerated a structural shift toward mandatory value-based care (VBC), notably through the rollout of the Transforming Episode Accountability Model (TEAM), which reintroduces mandatory bundled payment episodes—even as concerns mount about hospital readiness for this higher-stakes environment (bundled payments are back). Simultaneously, the 2026 Physician Fee Schedule final rule establishes a mandatory Ambulatory Specialty Model, which, starting January 2027, will hold outpatient specialists financially accountable for chronic condition management, embedding population health management deeper into specialist care (ambulatory specialty payment model). As CMS, under new leadership, positions itself as a forceful driver of VBC standardization ("big stick" approach), ACOs and provider organizations must reevaluate operational risks, readiness, and strategic fit amid the accelerating decline of voluntary models and increased reliance on mandatory structures.