Medicare Payment Policy
Expert articles and analysis related to medicare payment policy.
AI Summary — Last 30 Days
CMS is moving Medicare payment policy toward stronger primary care and technology-enabled chronic care management, with the CY 2027 PFS/MSSP rule drawing stakeholder pressure to strengthen ACO participation, reduce burden, and rebalance payment away from procedural care toward longitudinal population health. At the same time, the Trump administration is expanding CMMI’s ACCESS model in 2027 to additional chronic conditions such as COPD, substance use disorder, and tobacco cessation, signaling a push for scalable, condition-based payment experiments and potential cross-payer alignment for high-cost populations (ACCESS expansion). For VBC stakeholders, the upside of new primary care and chronic-condition payment opportunities is being paired with tighter Medicare Advantage risk-adjustment enforcement, including OIG audits and large settlements, raising the strategic importance of coding governance, documentation integrity, and compliance infrastructure.
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