Value-Based Contracting

CMS is pushing VBC through a more diversified model portfolio: the LEAD ACO model aims to broaden accountable care participation beyond traditional MSSP entrants, while ACCESS tests leaner, tech-enabled chronic disease management contracts with 150 participants and voluntary provider participation—signaling a Trump-era CMMI emphasis on scalable prevention, competition, and taxpayer protection. At the same time, CMS’s proposed resurrection and nationwide expansion of mandatory joint replacement bundles (CJR-X) reintroduces compulsory specialty risk, creating a strategic split for providers between voluntary primary-care/population-health models and mandatory episode-based accountability. For health systems, ACOs, and payers, the near-term positioning question is no longer whether VBC expands, but where to build capabilities first: MSSP/LEAD attribution and longitudinal care management, ACCESS-style technology partnerships, or orthopedic bundle performance infrastructure. [LEAD model overview](https://news.google.com/rss/articles/CBMizwFBVV95cUxPUEhSYU0tVElBdDRJd0FVNFpDaHlxODBaalZ1dmJWdHV3U3JBSkg1QmI3MmphVVFsdUpJRmJqbXBndnF2NV9GbXQ1RzVxckU0TEl4eVdabUd1ZVdDU1JqN0wyQTc5SjBfU3d0dmpWNHI5V