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Newsletter for Members and Partners
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POLICYMAKERS LOOK TO CUT COSTS AS HEALTH EXPENDITURES RISE
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Health care expenditures increased 7.2 percent from 2023 to 2024, according to the latest CMS report on National Health Expenditures. With total national expenditures at $5.3 trillion, growth is attributed to higher utilization, greater intensity of care, and rising prices.
The Trump administration released its Great Healthcare Plan, which aims to address growing costs by lowering prescription drug prices, reducing insurance premiums, increasing price transparency, and redirecting federal health subsidies directly to individuals rather than insurers.
NAACOS welcomes the administration’s emphasis on price transparency as an important step; however, meaningful system-wide transformation is essential to address the current drivers of rising costs and ensure long-term sustainability. Accountable care meets that promise with ACOs saving more than $34 billion since the inception of the programs, while preserving high-quality care. NAACOS is encouraging the administration to bolster accountable care by modernizing the program and fixing longstanding benchmarking and burden challenges. We’re excited that the Long-term Enhanced ACO Design Model (LEAD) will help meet this challenge and have been meeting with the administration on opportunities to strengthen MSSP.
Congress recognized the impact of accountable care by including incentives for value-based care providers and freezing qualifying alternative payment model (APM) participant thresholds in the Consolidated Appropriations Act, 2026. By encouraging new and sustaining existing participation in advanced APMs, Congress is supporting evidence-based efforts to reduce unnecessary spending, improve care coordination, and deliver higher-quality care for America’s seniors.
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HELP STRENGTHEN NAACOS ADVOCACY
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NAACOS would like members to share the contact information of their organization’s government relations or lobbyist contacts with our advocacy team. Having updated information will help improve coordination and alignment on advocacy efforts with Congress and the administration. Thank you for your support in strengthening our collective voice. Please send a list with contact information via email to [email protected].
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CONGRESS PROPOSES EXTENSION OF MEDICARE PROGRAMS
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NAACOS commends Congress for including a one-year extension of the Advanced APM incentive payments and freeze of qualifying thresholds in the Consolidated Appropriations Act of 2026. A NAACOS statement is available.
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- The proposal extends advanced APM incentives at 3.1 percent for Performance Year 2026/ Payment Year 2028 and lowers qualifying thresholds for Performance Year 2026 to 50 percent payment and 35 percent patients in the APM. The proposal does not address qualifying thresholds for 2025, which are currently set at 75 percent of payments and 50 percent of patients in the APM.
- It also extends Medicare’s telehealth programs for two years and hospital at home for five years.
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The House Republican and Democratic Doctors Caucuses are working together to solicit input on how to reform the Medicare Access and CHIP Reauthorization Act (MACRA) and invited insights from NAACOS. We briefed congressional staff and sent a letter outlining our recommendations to promote accountable care. NAACOS will continue to work closely with congressional leaders to ensure the benefits of accountable care are fully realized.
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UPDATED PI FOR MSSP ACOS RESOURCE
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Following the CMS announcement that the agency will not enforce requirements for MSSP ACOs to report Promoting Interoperability (PI) and include the ACO’s PI score in public reporting, NAACOS has updated its resource on PI for MSSP ACOs. The resource now includes updated FAQs reflecting the new enforcement decision and changes to PI policies effective beginning in 2026.
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- ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model. Applications for Cohort 1 are now open, Additional model details are in the Request for Applications (RFA). Join our NAACOS webinar to review the model on January 26 from 2-3:30 p.m. ET.
- LEAD (Long-term Enhanced ACO Design) Model is a 10-year voluntary model designed as the next ACO total cost of care (TCOC) Advanced APM. CMS will host a model webinar on January 29 from 2:00-3:00 p.m. ET. NAACOS will provide more insights on the model as model details are released.
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Alabama Physician Network, LLC
Birmingham, AL |
Eventus WholeHealth
Dartmouth, MA
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America’s MDE
Melbourne, FL |
Family Health ACO, LLC
New York, NY |
Asian American Accountable Care Organization, LLC
New York, NY |
Sailor Health
New York, NY |
Emory Healthcare Network
Atlanta, GA |
WakeMed Key Community Care, LLC
Raleigh, NC |
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STILL TIME TO REGISTER FOR CLINICAL OPERATIONS BOOT CAMP 201
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Register Now! The Clinical Operations Boot Camp 201 will be held January 28-30. Designed at the intermediate to advanced level, attendees will gain insights along with the practical tools and strategies needed to successfully operate a high-performing ACO. Hear directly from industry experts on topics such as Process over Outcomes: Operationalizing VBC Work in Your Payor Agreements, Documentation Mastery for CQM Reporting, and Specialty Engagement with CQM Reporting and much more! If you have already registered for the Data and Analytics 201 Boot Camp this week, please email [email protected] for information on the bundle discount.
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JOIN US AT THE SOUTHEAST REGIONAL MEETING FEBRUARY 12
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Register for Southeast Regional Meeting to be held on February 12 from 8:00 a.m. to 3:00 p.m. in Cary, North Carolina. Take part in engaging discussions and peer learning on topics such as: Aligning Systemwide Value-Based Care Goals with Practice Incentives, From Interoperability to Intelligence: How Lifepoint Operationalized AI Across its ACOs, Medicaid Federal Policy and North Carolina’s Unique Approach, and more. This meeting is sponsored by Persivia.
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- Midwest virtual meeting on February 18
- Northeast virtual meeting on March 5
- Northwest virtual meeting on March 17
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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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WILEMS RESOURCE GROUP PRESENTS 2026 COMPLIANCE WEBINAR
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NAACOS members receive preferred pricing: $800 for the first year and $450 for annual renewals. If your ACO has previously purchased a subscription, upgrading to this newest version will provide additional compliance and operational insight, as well as the addition of required policies around care coordination, beneficiary engagement, internal reporting on data and analytics, marketing material requirements, and more! The new and improved Compliance Manual is available on a subscription basis that will be renewed as necessary based on the release of updated regulatory guidance, but at least every 12 months. All subscribers will receive any updates made during the subscription year.
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JOIN US IN BALTIMORE FOR THE SPRING CONFERENCE
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Register now for the Spring 2026 Conference at the Hilton Baltimore Inner Harbor, April 22-24. The agenda will highlight insights from leading health care experts and CMS insiders, offering participants an in-depth look at the latest strategies driving health care transformation. In addition to dynamic presentations and panel discussions, the event provides valuable networking opportunities for participants, speakers, and vendors to connect, collaborate, and share best practices.
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Register early for in person or virtual to take advantage of the discounted rate, with special group rates also available for members.
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Reserve your space before it’s too late! The sponsor and exhibit program is filling quickly for the spring conference. Sponsorship application deadline is February 1. 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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- The Medicare Payment Advisory Commission (MedPAC) held a public meeting on January 15-16 to discuss Medicare payment adequacy and reports on other Medicare programs including Medicare Advantage and dual eligibles. MedPAC estimates Medicare Advantage overpayments will reach $76 billion this year, slightly lower than 2025 due to the phase-in of the new V28 risk-adjustment model.
- The Food and Drug Administration (FDA) recently released updated guidance loosening regulatory approach to certain digital health tools. The FDA guidance focused on clarifying the definition of certain clinical decision support (CDS) software inputs as patterns, signals, and medical information. The FDA further expands the scope of products that qualify as general wellness devices with limited oversight.
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