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Updates for Members and Partners
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STAY CONNECTED! SUBSCRIBE TO THE LISTSERV TODAY
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NAACOS re-launched its email-based ListServ to connect our members with one another. The ListServ replaces the Telegram system. Telegram will be discontinued on December 31. Subscribe to the email-based Listserv!
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COMING SOON: NEW ACO MODEL
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CMS Innovation Center is gearing up to unveil its next total cost of care model – the Long-Term Enhanced ACO Design (LEAD) Model. Early details briefly surfaced in a CMS public contractor funding notice before being pulled. NAACOS has been working closely with CMS to include key priorities in the model design. We are watching closely to see what makes the cut. Stay tuned — we’ll send a member alert as soon as CMS makes the model official.
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On January 8 from 12:00-1:00 pm ET, NAACOS will host the Contract Year 2027 MA Proposed Rule Webinar and Discussion. The webinar will cover proposed rule summaries and CMS feedback requests on areas such as Star Ratings and risk adjustment changes. Check out additional details and resource links. Register to attend the webinar.
On January 27 from 1:00-2:00 pm ET, NAACOS will host an in-depth discussion of the Ambulatory Specialty Model (ASM), which is a mandatory model focused on heart failure and low back pain episodes beginning in 2027. We will be discussing model details and our continued advocacy efforts next year. Register here to join the ASM discussion.
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SIGN UP FOR NAACOS’ ROUNDTABLES FOR 2026
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Interested in participating in one of NAACOS’ Deep Dive Roundtables in 2026? Register today to join one or more groups. These roundtables are topic-focused discussion groups designed to foster shared learning and inform NAACOS’ advocacy and education. Meeting agendas are driven by member input and are designed to take a deeper dive into operational and policy issues that members are facing. In 2026, roundtables include:
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COVERAGE DETERMINATIONS FOR SKIN SUBSTITUTES EFFECTIVE JANUARY 1
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All Medicare Administrative Contractors (MACs) will issue updated Final Local Coverage Determinations (LCDs) for Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers that will be effective January 1, 2026. These LCDs were set to be in place early this year but were delayed to collect additional evidence. CMS has categorized products as “covered,” “non-covered,” or “12-month status quo.” The updated final LCDs do not establish a coverage policy for the products in the 12-month status quo category; MACs will make individual claim determinations at their discretion and initiate a reconsideration of the LCDs by December 31, 2026. For “non-covered” products MACs will review additional evidence submitted by sponsors that demonstrates that the product is reasonable and necessary for the Medicare population for reconsideration of the LCDs in early 2027. Additional information on CMS Local Coverage Determination Processes and Timelines is available.
While CMS has addressed challenges with payment policy and coverage determinations for skin substitutes, we remain concerned that some ACOs with higher skin substitute spending than trend will be unfairly penalized. NAACOS continues to engage with the administration to seek policy changes to address this issue.
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ACA TAX CREDITS EXTENSION REMAINS UNCERTAIN AS YEAR-END APPROACHES
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Negotiations over extending the Affordable Care Act’s enhanced premium tax credits have made little progress, increasing the likelihood that the subsidies will expire at the end of the year and lead to higher health insurance premiums. Last week, the Senate rejected separate Republican and Democratic proposals to address the issue.
In the House, Republican leadership has announced plans to vote on a broader health care package focused on lowering premiums through cost-sharing reductions, expanded access to association health plans, and increased transparency for pharmacy benefit managers. The package does not include an extension of the ACA subsidies.
President Trump has not endorsed a specific health care affordability proposal, and negotiations continue as Congress prepares to recess on December 19. While the tax credits are set to expire on December 31, some lawmakers now view late January—when current government funding expires—as the next potential opportunity for action, after premium increases have begun and open enrollment has closed.
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CMS PROVIDES RELIEF ON PROMOTING INTEROPERABILITY
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Last week, CMS announced it will exercise its enforcement discretion to not enforce the new Promoting Interoperability (PI) requirements for MSSP ACOs for Performance Year (PY) 2025.
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- Under current regulations, MSSP ACOs are required to report PI with PY 2025 being the first year these requirements were in effect.
- CMS indicated that it is using enforcement discretion because CMS was unable to release guidance to ACOs on APM entity level reporting for PI due to the government shutdown and other implementation challenges. CMS indicated that ACOs should plan to comply with these policies for PY 2026.
- ACO clinicians who are subject to MIPS (i.e., not Partial QPs or QPs) are still required to report PI under their MIPS obligations.
- Only the MSSP-specific PI requirements are affected by this decision. That is, ACOs who are meeting QP and partial QP requirements are not required to report.
- ACOs may still choose to report PI. CMS notes that any data submitted will result in a MIPS score and payment adjustment, if applicable.
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CMS LAUNCHES MAHA ELEVATE MODEL
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CONNECT AND LEARN AT THE SPRING 2026 CONFERENCE
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Register today for the Spring 2026 Conference at the Hilton Baltimore Inner Harbor, April 22–24. Expect powerful insights from leading health care experts and CMS insiders, interactive sessions, and lively panel discussions, all designed to explore the latest innovations in health care transformation. Plus, enjoy meaningful networking with fellow attendees, speakers, and vendors. Be part of the national conversation shaping the future of value-based care. Join us in person or online, and register early to secure the best rate!
Reserve your room early at the NAACOS discounted rate. The discounted rate is $249 per night plus taxes and fees. This discounted rate is good through March 3, 2026, or until the block is full. The hotel will not release additional rooms to us at the discounted rate. Please book early.
Limited sponsorships available! The sponsor and exhibit program is filling quickly for the spring conference. Reserve your space today! Please note, all sponsorships and exhibit space are on a first come first served basis, and space is assigned in the order we receive applications.
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HEAR FROM TOP-PERFORMING ACOS AT BOOT CAMP 201
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Register for the the Data and Analytics Boot Camp 201, held January 21-23, followed by the Clinical Operations Boot Camp 201 on January 28-30. Designed for intermediate to advanced participants, these sessions provide a deeper understanding of Medicare accountable care and population health, equipping you with the operational and administrative tools needed to run a high-performing ACO. Learn directly from industry experts on topics including: Quality Performance Analytics, Calculating Risk/Risk Adjustment Models, Integrating Data Insights, Reconciling & Aligning VBC Contracts, Specialty Engagement with CQM Reporting.
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REGISTER TODAY FOR EARLY 2026 REGIONAL MEETINGS
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Registration is open for the South Central in-person regional meeting on January 14 from 8:00 a.m. to 3:00 p.m. in Arlington, Texas. Take part in engaging discussions and peer learning on topics such as: The Human Side of Care: Combating Loneliness for Better Outcomes, Moving the Needle: Using Incentives to Drive Provider Engagement in VBC, Redefining Partnerships: Collaboration Beyond Traditional Payer Models and more.
Registration is also open for:
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- Southeast in-person regional meeting on February 12 in Cary, N.C.,
- Midwest virtual regional meeting on February 8,
- Northeast virtual regional meeting on March 5, and the
- Northwest virtual regional meeting on March 17.
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Interactive virtual meetings explore operational best practices and strategies to improve quality and patient outcomes. Don’t miss these opportunities to gain practical insights, ask questions in real time, and strengthen your ACO’s success for the year ahead.
Regional meetings are open to NAACOS members, non-member ACOs, and value-based care providers. In-person events are $50 for members and $250 for non-members. Virtual meetings are free for members to attend. These events are not open to non-sponsoring business partners. Interested in presenting? We welcome submissions! Please email [email protected].
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ATTEND XCCELERATE 2026: JANUARY 25-27 IN SAN FRANCISCO
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The future of health care is being rewritten, with AI leading the way. Join us at Xccelerate 2026: The Health AI + Outcomes Conference by Innovaccer, where innovators and leaders will explore how intelligence, data, and collaboration are driving measurable improvements in care and outcomes. Emily Brower, CEO of NAACOS, will share insights on value-based care transformation and what’s driving strong ACO performance today.
As a valued NAACOS ACO member, you’re eligible for exclusive complimentary pricing. Use code NAXCC at registration to claim this offer.
Presented by Innovaccer, in collaboration with NAACOS, KLAS, CHIME, and AMGA. Be part of what’s next in health care at Xccelerate 2026.
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- The Medicare Payment Advisory Committee (MedPAC) held their last public meeting of the year on December 4-5. The commission discussed Medicare payment adequacy and approaches to improve Medicare’s payment systems.
- The Medicaid and CHIP Payment and Access Commission (MACPAC) held a public meeting to discuss transitions to adult coverage, implementing community engagement requirements, and state and federal tools to ensure accountability of managed care organizations (MCOs).
- JAMA Health Forum published an article on the future of Medicare Advantage, highlighting forecasted programmatic changes focused on Star Ratings system, cost containment, coding practices, and the value of supplemental benefits.
- Another JAMA Health Forum article outlines modernizing risk adjustment methods that support value-based care while minimizing documentation burdens on clinicians. The article underscores that risk adjustment changes must balance accuracy, efficiency, equity, and clinician sustainability, such as leveraging interoperability standards to streamline data exchange and aligning with clinical data for patient care.
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