Cost & Affordability
Expert articles and analysis related to cost & affordability.
AI Summary — Last 7 Days
Cost-and-affordability pressure is showing up across VBC models: nursing homes are being urged to align more tightly with ACOs as CMS expands accountable care, while ACOs are scrutinizing whether low-value “wellness” utilization can erode shared savings rather than improve outcomes. Medicaid drug-spend strategy also remains unsettled under the Trump administration, with KFF cautioning that the GENEROUS Model’s savings potential depends heavily on confidential model terms and the interaction with existing Medicaid rebates (KFF analysis). Meanwhile, Medicare Advantage headwinds—slower enrollment growth and continued plan/provider tension—reinforce why ACOs, bundled payments, and drug-pricing models are becoming more central affordability levers for CMS, payers, and risk-bearing providers (HFMA).
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