NAACOS Publishes Specialty Engagement Toolkit to Further Collaboration in Accountable Care
Resource details best practices and tools to support accountable care across the continuum
WASHINGTON (April 29, 2026) – The National Association of ACOs (NAACOS) has released the Specialty Engagement in Accountable Care Toolkit, a resource outlining core components for effectively engaging specialty care providers in accountable care with tools and best practices to strengthen and sustain high-quality care across the continuum.
The toolkit is being made available at pivotal moment as the Centers for Medicare and Medicaid Services’ (CMS) Innovation Center seeks to further specialty care involvement in accountable approaches, including the LEAD (Long-term Enhanced ACO Design) Model, Ambulatory Specialty Model, TEAM (Transforming Episode Accountability Model), and CJR-X (Comprehensive Care for Joint Replacement Expanded) Model.
“The next phase of health care transformation will require that specialty care is meaningfully integrated into accountable care models,” said Emily Brower, president and chief executive officer of NAACOS. “With CMS advancing new specialty‑focused alternative payment models, clinical teams need strategies that build on their accountable care foundation. This toolkit helps organizations prepare by offering resources to engage specialists, align incentives, and scale accountable care approaches.”
Specialty care costs account for the majority of total health care spending, amounting to more than $2 trillion in 2024. Yet specialists often face barriers to participation in value-based arrangements. The toolkit was developed by NAACOS with a workgroup of clinical leaders including specialists, and operational and analytical experts, who shared their real-world experiences.
The toolkit outlines six domains and corresponding tools integral to aligning incentives, improving coordination, and advancing shared accountability across the care continuum:
- Data, analytics, and dashboards
- Patient entry, attribution, and clinical pathways
- Specialist alignment and referral network planning
- Developing and aligning meaningful incentives
- Episodes of care payment models
- Advanced specialty care payment models
“Specialists play a critical role in working with primary care to support patients with complex and chronic conditions — populations that often drive avoidable costs and face care coordination challenges,” said Brower. “Integrating specialty care within accountable frameworks allows organizations to continue to create greater opportunities to improve outcomes and reduce costs.”
The Specialty Engagement in Accountable Care Toolkit is available as a free download on the NAACOS website. It serves as a complement to previous resources: the Creating a Sustainable Future for Value-based Care: Playbook of Voluntary Best Practices for VBC Payment Arrangements and The Future of Sustainable Value-Based Payment: Voluntary Best Practices to Advance Data Sharing, developed by NAACOS in partnership with AHIP and the American Medical Association, which outline best practices for aligning payment with quality, cost, and patient experience across payers.
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About NAACOS. The National Association of ACOs (NAACOS) is a member-led and member-governed nonprofit of more than 500 ACOs and value-based care entities in Medicare, Medicaid, and commercial insurance working on behalf of physicians, health systems, and other providers across the nation to improve quality of care for patients and reduce health care cost. NAACOS represents more than 10 million beneficiary lives through Medicare’s population health-focused payment and delivery models.