If we thought that change was accelerating in the last couple of years, we may be in for a “You ain’t seen nothing yet” moment. In the past several days, President-elect Trump nominated personnel to lead the Department of Health and Human Services (Rep. Tom Price, a Republican from Georgia) and CMS (Seema Verma, a health policy consultant). Not surprisingly, both are allies, and have their eyes on “repealing and replacing” the Affordable Care Act. Repealing is the easy part, but replacing it will be much more difficult. The two of them have actively spoken out against value-based payment programs, including the bundled payment initiatives, and Price previously has introduced legislation specifically to dismantle those programs. He also has criticized the Comprehensive Care for Joint Replacement (CJR) program, saying that CMS has overstepped its authority in rolling it out.