Cost & Affordability
Expert articles and analysis related to cost & affordability.
AI Summary — Last 30 Days
CMS is moving cost-and-affordability policy toward more direct provider accountability: the proposed resurrection and nationwide expansion of mandatory joint replacement bundles through CJR-X would deepen episode-based risk for hospitals and MSK networks, while TEAM reinforces that mandatory bundles are becoming a core Medicare cost-control tool rather than a niche demonstration (Hall Render on CJR-X). At the same time, CMS is testing the voluntary ACCESS model with 150 participants, linking chronic disease payment to outcomes enabled by technology partners—signaling a parallel strategy of using scalable tech-enabled care management to lower longitudinal total cost of care (Healthcare Finance on ACCESS). For health systems, ACOs, and payers, the strategic tension is clear: Medicare VBC is expanding both mandatory downside exposure in procedural episodes and optional infrastructure-heavy models in chronic care, raising the premium on data integration, specialist alignment, post-acute control, biosimilar adoption, and repeatable cost-management playbooks.
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