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PROPOSED CY 2026 MEDICARE PHYSICIAN FEE SCHEDULE RELEASED
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On July 14, CMS released the Calendar Year (CY) 2026 Medicare Physician Fee Schedule (PFS) proposed rule. It proposes significant changes to payment for skin substitutes but contains minimal changes for the Medicare Shared Savings Program (MSSP) and does not address issues that are of highest importance to ACOs that NAACOS has been advocating for.
Register for NAACOS’ webinar reviewing key proposals on July 30 from 2:00 to 3:15pm ET. The rule is summarized in several fact sheets provided by CMS: PFS Fact Sheet, MSSP Fact Sheet, Quality Payment Program (QPP) Fact Sheet, and Ambulatory Specialty Model (ASM) Fact Sheet.
Comments to CMS in response to the proposed rule are due on September 12 and may be submitted on the regulations.gov website. NAACOS is seeking member input on the proposals in this rule, which will help shape our comments. Please share your feedback by emailing us at [email protected]. NAACOS will provide draft comments ahead of the deadline. CMS will review comments and issue a final rule later this year, typically by November 1.
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EXCELLENCE AWARDS NOMINATIONS OPEN
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The call for submissions for the 2025 NAACOS Excellence Awards is open through August 5, 2025. Recipients of the award exemplify how value-based care can transform health care delivery by improving quality and outcomes, lowering or slowing growth of costs, and increasing patient and provider satisfaction. Awardees will present on a panel at the Fall 2025 NAACOS conference. Get information on past winners and the awards criteria.
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LAWMAKERS WORK TO WRAP UP BUSINESS BEFORE AUGUST RECESS
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Congress is scheduled to depart Washington in the coming days for the August recess. Prior to departure, lawmakers are preparing for a jam-packed legislative session in September.
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- Appropriations and Health Extenders— Congress has until September 30 to reach an agreement to extend government funding and address a long list of expiring health programs, including telehealth flexibilities, hospital at home, disproportionate share hospital payments, among others. Committee leaders in Congress have expressed interest in reviving the bipartisan December health care package that paired pharmacy benefit manager (PBM) reforms with extensions of expiring health programs and physician payment issues such as the advanced alternative payment model (APM) incentive extension. The path forward on government funding and health extenders remains unclear as Republicans and Democrats have struggled to engage in bipartisan discussions around legislative priorities related to government funding levels. Ongoing disagreements have slowed the process and will result in high stakes fights in September before the funding deadline.
- MA Oversight— The House Ways and Means Committee held a hearing this week to provide oversight on the Medicare Advantage (MA) program. The hearing focused on past lessons, current insights, and future opportunities to improve the program.
- Reconciliation 2.0— The Congressional Budget Office (CBO) projects that the reconciliation bill passed by Congressional Republicans in July will increase the federal deficit by $3.4 trillion and increase the uninsured rate by nearly 10 million people due to changes in Medicaid and the Affordable Care Act (ACA). Speaker Mike Johnson (R-LA) and House Budget Committee Chairman Jodey Arrington (R-TX) have expressed interest in passing another reconciliation bill that would seek further cuts to health programs, including Medicaid and Medicare. During debate on the One Big Beautiful Bill Act (OBBBA) some lawmakers expressed interest in making modifications to Medicaid’s Federal Medical Assistance Percentage (FMAP), changing Medicare’s site neutral payments, and addressing MA coding issues.
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CMS PUBLISHES LIST OF UNPAID QPS
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CMS began paying advanced APM incentives for Performance Year 2023/ Payment Year 2025 earlier this summer. On July 1, 2025, CMS published a list of unpaid qualifying APM participants (QPs) for Payment Year 2025. Clinicians have until September 1 to update their payment information. NAACOS members have noticed a significant increase in the number of clinicians who have been included on the non-payment list. NAACOS has been in touch with CMS staff who are aware of the issue and are working to resolve it. In the meantime, if your ACO is seeing an increase in the number of practices or clinicians on the 2025 non-payment list, please contact [email protected].
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CMS RELEASES 2026 PROPOSED OUTPATIENT HOSPITAL RULE
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CMS is proposing to increase the Outpatient Prospective Payment System (OPPS) by 2.4 percent and proposing an update factor of 2.4 percent to the ambulatory surgical center (ASC) rates. Additionally in the OPPS, CMS proposes policy changes to the way skin substitute products are paid for when furnished in the hospital outpatient setting, intended to align with payment policy changes for skin substitutes paid for under the PFS. Other proposals include expanding site neutral policies for drug administration services and eliminating the inpatient only list.
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REMINDER: DEADLINE TO ADD ACO PARTICIPANTS FOR 2026
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The final deadline to add ACO Participant TINs for newly applying, renewing, and currently participating ACOs in MSSP for Performance Year (PY) 2026 is August 1 at 12:00 pm ET. The deadline for ACO REACH participants to add providers (Participant and Preferred) for PY 2026 is August 1 at 11:59 pm ET. The final deadline to drop ACO participants for PY 2026 is September 8. Additional information on the MSSP application and change request cycle can be found on the Application Types & Timeline webpage.
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NEW RECORDED WEBINARS ON QUALITY STRATEGY
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Check out these pre-recorded sessions on managing quality requirements across your value-based care contracts, which were initially presented during the Spring 2025 Conference quality workshop.
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- In Part 1: Aligning Quality Strategy Across Payer Contracts, Wilson Gabbard with Advocate Health discusses the organization’s strategy for closing quality gaps and maximizing the impact of quality improvement efforts when managing multiple contracts.
- In Part 2: Balancing the Quality Tightrope, Dr. Mathew Philip with Duly Health and Care describes the organization’s strategy for managing quality demands across payers by quantifying the financial impact of gap closure efforts.
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Both presentations are accompanied by interactive worksheets that members can download and use for their own quality strategies.
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AGENDA ANNOUNCED FOR THE FALL CONFERENCE
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Connect and learn at the Fall 2025 Conference on October 8-10 at the Marriott Marquis Washington, D.C.! The agenda features expert-led sessions that include Chris Klomp and Abe Sutton of CMS, as they share key insights into evolving federal value-based care initiatives, and Dr. Pippa Shulman of Medically Home, a pioneer in delivering acute care in the home. The agenda also offers networking opportunities for participants, speakers, and vendors to share ideas, explore partnerships, or gain insight. Register before August 15 for the in-person conference and receive a discount of $300 per person. Can’t attend in person? Register for our live webcast before August 15 and receive a discount of $100 per person.
Reserve your hotel room by August 15 (or until sold out) to receive the NAACOS’ discounted rate of $349.00 per night plus taxes and fees.
The sponsor and exhibit program are filling fast! 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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FIVE REGIONAL MEETINGS STARTING IN TWO WEEKS
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Register today for the upcoming regional meetings in August and September. Regional meetings provide an opportunity for value-based care presentations and discussions with regional health care leaders from provider groups, payers, and thought leaders from the care continuum in value-based care contracts. For 2025, we will hold two additional in-person meetings, a Midwest Regional Meeting on August 15 in Indianapolis and a Southwest Regional Meeting with location and date to be determined. Registration for the Southwest meeting will open in early August. In addition, we are starting to plan for an in-person South Central/Gulf regional meeting to occur in early 2026. If you are interested in joining a focus group to help plan this meeting, email [email protected].
Our regional events are open to NAACOS members, non-member ACOs, and value-based care providers. In-person events are $250 per registrant, and each NAACOS ACO and value-based care provider member receives one complimentary registration per calendar year, with unlimited additional registrations to be purchased at the prevailing rate. Contact [email protected] to utilize your complimentary registration or with any questions.
Virtual events will be held for four other regions in August and September. There is no charge to attend the virtual regional events for NAACOS members, non-member ACOs, and value-based care providers. These events are not open to non-sponsoring business partners.
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If you are interested in speaking on any of the agenda topics listed for your region, please email [email protected]. Watch for updates and additional registration links in future newsletters and on our Regional Meeting Webpage.
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SUMMER AFFINITY GROUPS CONTINUE JULY 29
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Role-based member Affinity Group discussions are held Tuesdays. We hope you were able to join Tuesday’s Operations Affinity Group, and we have more group meetings coming for our summer round of discussions.
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If you are new to NAACOS, Affinity Groups are peer-to-peer role-focused discussion groups for our members to exchange information, ideas, and brainstorm current issues. These groups meet four times a year with two virtual sessions and two in-person sessions at our Spring and Fall Conferences.
You can find more information including registration at NAACOS Affinity Group
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NAACOS PARTNERS: NEW OPPORTUNITY TO SPONSOR REGIONAL MEETINGS
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NAACOS is now offering the exciting opportunity to sponsor our new virtual regional meetings in August and September 2025! These one-day events provide a forum for sharing best practices and education targeted toward regional concerns of ACOs and value-based care providers, as well as networking opportunities across the full care continuum. Each sponsorship includes having a speaker on a relevant topic panel, three complimentary registrations to attend the virtual event, recognition in event promotions, and the opportunity to host a virtual reception at the conclusion of the day, where you can provide a live demo, have a client available for questions, or network with attendees. Sponsors also receive a pre- and post-meeting attendee list. We have the following regions and dates available:
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- August 6: 1:00 pm to 5:00 pm ET – Mid-Atlantic Region
- August 22: 10:00 am to 5:00 pm ET – Northeast Region
- September 16: 11:00 am to 6:00 pm ET – Northwest/Rocky Mountain Region
- September 26: 1:00 pm to 5:00 pm ET – Southeast Region
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Each event will have a sole sponsor and are available on a first come, first served basis. Sponsorship is $10,000 for one event, and $17,000 for two events. Contact [email protected] to find out more or reserve your sponsorship today!
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- A recent Health Affairs Forefront article presents integrated ACOs as a strategy for caring for beneficiaries who are dually eligible for Medicare and Medicaid.
- Becker’s Hospital Review is seeking nominations for ACOs to be included in its 2025 ACOs to Know list. Complete the brief nomination form by July 31, 2025, to nominate your ACO.
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