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Home-based care providers have long looked to both the Centers for Medicare & Medicaid Services and Medicare Advantage plans to push forward value-based care, but that balance may be shifting. CMS value-based care home health growth is now outpacing MA-driven momentum, as federal models create clearer paths toward risk-based partnerships, experts said in a panel at Home Health Care News’ PAYER Summit in June.
Why CMS Value-Based Care Home Health Models Are Gaining Ground
CMS is driving value-based care growth more than MA, as federal models such as home health value-based purchasing and the Transforming Episode Accountability Model create clearer paths toward risk-based partnerships. “It’s a combination of increasing outcomes, creating value and partnerships. That’s really seen in the CMS space,” Devin Woodley, vice president of managed care contracting at VNS Health, said during the panel.
The Contrast With Medicare Advantage and Managed Medicaid
“When it comes to Medicare Advantage and managed Medicaid, we’ve actually seen the opposite,” Woodley said, drawing a clear distinction between the momentum home-based care providers are experiencing through federal CMS models versus the trajectory of insurer-driven value-based arrangements.
VNS Health’s Vantage Point on This CMS Value-Based Care Home Health Shift
New York City-based nonprofit VNS Health provides home care, hospice and other healthcare services for more than 99,000 patients daily across the city’s five boroughs and surrounding counties, giving Woodley’s organization a substantial, real-world vantage point on how value-based contracting dynamics are shifting across both federal and commercial payer relationships.
Why VNS Health’s Scale Matters for This Assessment
An organization serving nearly 100,000 patients daily across such a broad service area is likely to have concurrent visibility into a wide range of both CMS-driven and MA-driven value-based arrangements, lending particular weight to Woodley’s observation that the two payer channels are now moving in opposite directions.
How This Fits the Broader Medicare Advantage Pullback
This shift comes amid a well-documented pattern of Medicare Advantage insurers scaling back their footprint, with several major companies reducing membership, exiting markets, or discontinuing specific plan types heading into 2027. As MA insurers navigate cost pressures and star ratings disputes, the reduced appetite for expansive value-based partnerships in that channel appears to be creating an opening for CMS’s own federal models to fill the gap.
Why Federal Models Offer More Predictability
Unlike Medicare Advantage value-based arrangements, which can shift significantly as individual insurers adjust their strategies or exit specific markets, federal models like HHVBP and TEAM offer home-based care providers a more consistent regulatory framework to build risk-based partnerships around, since these programs operate under CMS’s own rulemaking rather than depending on the strategic decisions of any single private insurer.
What This CMS Value-Based Care Home Health Shift Means Going Forward
With Medicare Advantage insurers continuing to pull back membership and market presence heading into 2027, home-based care providers may increasingly prioritize building relationships and operational capabilities around CMS’s federal value-based models rather than betting heavily on MA-driven arrangements that could prove less stable. Given VNS Health’s direct experience navigating both channels simultaneously, other home health and hospice providers may find Woodley’s assessment a useful signal for where to focus their own value-based care strategy investments going forward.
What to Watch Going Forward
As CMS continues advancing models like HHVBP and TEAM, industry observers will likely watch whether this federal-driven momentum in CMS value-based care home health partnerships continues accelerating even as Medicare Advantage insurers navigate their own cost and market pressures. Given the panel discussion’s framing of this as a genuine shift in balance rather than a temporary fluctuation, home-based care providers may need to recalibrate how they allocate resources between pursuing MA-based value-based contracts versus building deeper operational alignment with CMS’s own evolving federal payment models.
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