|
Updates for Members and Partners
|
|
|
|
HELP INFORM NAACOS ADVOCACY ON ADVANCED APM INCENTIVES AND THRESHOLDS
|
NAACOS is seeking input from ACOs to help determine the appropriate level of the qualifying participant (QP) thresholds. Beginning in Performance Year (PY) 2025, ACOs must meet higher QP thresholds — 75 percent of Medicare payments or 50 percent of Medicare patients — to qualify as advanced alternative payment model (APM) participants (i.e., QPs). We are calling on Congress to reinstate the advanced APM incentives and lower QP thresholds. Please complete this brief survey to inform us of the appropriate level for QP thresholds.
|
|
|
|
FEDERAL GOVERNMENT SHUTDOWN: WHAT HAPPENS NEXT
|
On Tuesday, Congress failed to pass legislation to extend federal funding due to a partisan impasse over extending health care tax credits and reversing Medicaid cuts enacted earlier this year. As a result, a partial government shutdown began on October 1, 2025. This resource from our consultants at Hart Health Strategies provides an overview of the shutdown status and impact on federal agencies and programs. Of note:
|
- CMS does not anticipate delays in payments to ACOs. Advance Investment Payment (AIP) are scheduled for early October, and shared savings payments for MSSP are scheduled for mid-October. Similarly, CMS does not anticipate delays in demand and remittance instructions for ACOs owing shared losses.
- Telehealth policies will generally revert to pre-pandemic requirements; however, certain ACOs can utilize telehealth waivers. See the CMS guidance from on telehealth and telehealth fact sheets for MSSP ACOs and REACH ACOs.
|
The NAACOS government affairs team is closely following the government shutdown and will provide updates as the situation continues to evolve. If you need assistance, or experience disruptions at CMS due to the shutdown, please contact us at [email protected].
|
|
|
|
CMS ANNOUNCES CHANGES TO THE AHEAD MODEL
|
On September 2, CMS announced key changes, including a new name to the “Achieving Healthcare Efficiency through Accountable Design” (AHEAD) model to help advance the Innovation Center’s strategic pillars. Other updates to the model include:
|
|
|
- Implementing a geographic attribution component for traditional Medicare beneficiaries not attributed to other Medicare ACO programs.
- Requiring that participating states/regions implement at least two policies focused on promoting choice and competition in their health care markets.
- Adding a new “Population Health Accountability Plan” to the model to emphasize preventive care.
- Establishing new transparency requirements around total cost of care and primary care investment targets in the model.
- Extending the model to run through December 31, 2035 for all cohorts.
|
HHS SEEKS NOMINATIONS TO SERVE ON FEDERAL HEALTHCARE ADVISORY COMMITTEE
|
The U.S. Department of Health and Human Services (HHS) is seeking nominations of individuals to serve on the new Healthcare Advisory Committee, which will provide strategic recommendations to the HHS Secretary and CMS Administrator. The new advisory committee is intended to improve health care payment and delivery across federal programs. CMS encourages individuals with expertise in chronic disease prevention and management, federally administered health care financing, and delivery system reform to apply. Nominations are due by September 22; additional information is available.
|
|
|
|
REGISTER FOR 3RD QUARTER PARTNER CALL TO BE ELIGIBLE FOR SPECIAL SPONSOR PACKAGES
|
NAACOS Partners! Join us on September 18 at 12:30 pm ET for an engaging and informative call exclusively for Partner Circle, Business Partners, and Alliance Partners. NAACOS staff will provide an update on our latest initiatives and new opportunities for you to engage with our value-based care audience. Hear about maximizing your Fall Conference opportunities and take advantage of special discounted sponsorship packages at the conference and beyond! Don’t miss this chance to fully utilize the benefits of your NAACOS partnership. This meeting is only open to Partners.
|
DON’T MISS OUR UPCOMING SEPTEMBER REGIONAL MEETINGS
|
Register today for the upcoming regional meetings occurring in September. These regional meetings provide an opportunity to engage in 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. Registration is open for the Northwest Virtual Meeting, and Southeast Virtual Meeting,.
In addition, we are starting to plan for an in person South Central/Gulf regional meeting scheduled for early 2026. If you are interested in joining a focus group to help shape this meeting, please 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 additional unlimited additional registrations to be purchased at the prevailing rate. Contact [email protected] to utilize your complimentary registration or with any questions. These events are not open to non-sponsoring business partners.
|
If you are interested in speaking on any of the agenda topics listed for your region, please reply to [email protected]. Watch for updates and additional registration links in future newsletters and on our Regional Meeting Webpage.
|
TAKE A DEEP DIVE WITH A PRE-CONFERENCE WORKSHOP THIS FALL
|
Connect and learn at the Marriott Marquis Washington, D.C., on October 8-10 at the Fall 2025 Conference! The agenda features expert-led sessions and in conjunction with the main conference, we offer pre-conference workshops that take a deep dive into key issues facing the industry. Pre-conference workshops are held concurrently on Wednesday, October 8 from 1:00 – 5:00 pm ET. These workshops require separate registration from the main meeting. Topics include:
|
- Payer-Provider Partnerships in the Community chaired by Diwen Chen, NAACOS
- Compliance & Legal Scuba Session chaired by Kimberly Busenbark, Wilems Resource Group
- Connected Care: Aligning Leaders, Providers and Patients for Better Outcomes chaired by Michelle Mirkovič, Southwestern Health Resources
|
Register today for the in-person conference or live webcast! The entire conference will be recorded, except for the pre-conference workshops. All participants, both in-person and virtual, will be able to view any sessions they missed live for six months following the conference.
**To add a pre-conference workshop to an existing registration, please contact Emily Perron.**
|
- NAACOS is co-sponsoring a Capitol Hill reception on Thursday, September 11 at 4:30 p.m. ET to celebrate primary care, value-based care momentum, and the release of The Zen Lobbyist by Gary Jacobs. NAACOS members in the D.C. area or attending the Fall Advocacy Summit are welcome to attend.
- Health and Human Services (HHS) Sec. Robert F. Kennedy Jr. testified before the Senate Finance Committee on President Trump’s “Make America Healthy Again” agenda and upcoming HHS initiatives.
- The House Energy and Commerce Health Subcommittee held a hearing to examine how artificial intelligence can improve care delivery, reduce administrative burden, and support patient engagement in the health system.
- The Medicare Payment Advisory Commission (MedPAC) resumes their public meetings on September 4 and 5.
- In a recent Health Affairs Forefront article, authors Michael Chernew and J. Michael McWilliams offer policy solutions to address challenges with the Accountable Care Prospective Trend (ACPT).
- A recent KFF article stated that Medicare Advantage has surpassed 54 percent of eligible beneficiaries in 2025. Additionally, Chronic Condition Special Needs Plans had a 70 percent enrollment increase from 2024 to 2025. Federal spending on MA plans is currently 20 percent higher per person than traditional Medicare, totaling approximately $84 billion.
- A Modern Healthcare article stated that $665 billion of the $1.2 trillion reduction in Medicaid funding could directly affect hospitals. States may also face tough decisions on coverage and provider payments.
- A recent Health Affairs article highlighted that national health expenditures are projected to grow 7.1 percent in 2025, driven by increased use of health care services and goods post-pandemic. National health care expenditure growth (averaging 5.8 percent) is expected to outpace that for the gross domestic product (GDP) each year of the 2024–33 projection period, and result in a health share of GDP that reaches 20.3 percent by 2033.
|
|
|
|
