The Affordable Care Act created the most significant changes to Medicare since its inception to create new incentives for health care providers to deliver higher quality care at a lower cost. Under the direction of the Centers for Medicare and Medicaid Services (CMS) Innovation Center, these policies — including Accountable Care Organization program, bundled payment, and primary care reforms — continue to evolve. Understanding whether these models are successful in reducing spending growth, and how they can be modified to achieve this goal, is central to the future of Traditional Medicare.
Center for Advancing Health Policy through Research
Traditional Medicare
Traditional Medicare is public health insurance that provides coverage to about half of the 62 million adults aged 65 and older who are covered by the federally-funded Medicare insurance program.
Recent News
This piece, authored by Hayden Rooke-Ley, argues that while the Trump administration’s One Big Beautiful Bill Act threatens to gut Medicaid funding by nearly $1 trillion over a decade, states still have powerful tools to protect coverage and even strengthen their healthcare systems. By capping inflated prices in the private insurance market and redirecting those savings to Medicaid—where every dollar is federally matched—states can blunt the impact of federal cuts, support vulnerable providers, and reduce systemic inequities.
Harvard Medical School
Hospital-SNF Integration and APM Participation
This article highlights a study published in JAMA Network Open that explores the impact of hospital-SNF (skilled nursing facility) integration on participation in alternative payment models (APMs), particularly focusing on the Bundled Payments for Care Improvement Advanced (BPCI-A) program. The findings reveal that while integration influences APM participation, the effects are complex, pointing to broader implications for healthcare systems.
Health Affairs Forefront
Are Changes To The Medicare Physician Fee Schedule Driving Value In US Health Care?
The Medicare Physician Fee Schedule is a cornerstone of U.S. healthcare policy, directly influencing how services are priced and covered. This Health Affairs blog delves into a brief analysis of the CY25 Physician Fee Schedule Proposed Changes and what impact it could have moving forward.
Health Affairs Forefront
2025 Medicare Advantage Advance Notice: Small Changes, Missed Opportunities
Under the CMS 2025 Medicare Advantage Advance Notice, CAHPR researchers emphasize the expected revenue increases and minor changes in risk adjustment practices; highlighting the impactful changes on the horizon and the critical reforms that still await attention.
Health Affairs Forefront
It’s Time For A New Season Of Episode-Based Payment
Dr. Ryan et al., talk about the reforming episode-based payment models to achieve savings and quality in Medicare
Continuum Magazine
Medicare’s Goldilocks Problem
An Interview with Health Services, Policy and Practice Professor Andrew Ryan