|
Updates for Members and Partners
|
|
|
|
NAACOS ADVOCACY SUMMIT BRINGS ACO VOICES TO WASHINGTON
|
NAACOS hosted our Fall Advocacy Summit in Washington, D.C. last week where 70 ACO leaders from across the country convened to advocate for the future of value-based care. The advocacy summit featured:
|
- Insights from CMS senior leaders including Alec Aramanda, Principal Deputy Director, Center for Medicare; Joe Albanese, Director of Policy, Center for Medicare; and Gary Bacher, Chief Strategy Officer, CMS Innovation Center
- A panel with representation from payer associations, including AHIP, Alliance of Community Health Plans, Association for Community Affiliated Plans, and National PACE Association highlighted how payers are responding to increased oversight of Medicare Advantage (MA) from Congress and the Administration as well as opportunities to better partner with providers in accountable care.
- A Congressional staff panel provided a robust discussion on the future of Medicare physician payment reform, bringing together staff leaders from the House Republican and Democratic Doctors Caucuses, along with former health staff from the Ways and Means and Senate Finance Committees.
|
|
|
DIGITAL QUALITY LEGISLATION
|
Following advocacy from NAACOS and its members, the House Ways and Means Committee voted this week to advance the Health Care Efficiency Through Flexibility Act, which requires CMS to pilot-test digital quality reporting approaches while maintaining current quality reporting options during the transition. This legislation directly responds to concerns raised by NAACOS members and will give ACOs the time and flexibility needed to transition to digital quality reporting. Read our statement on the markup.
|
|
|
NAACOS SUBMITS COMMENTS ON THE 2026 MPFS RULE
|
On September 12, NAACOS submitted feedback to CMS in response to the 2026 Medicare Physician Fee Schedule (MPFS) proposed rule. Our comments expressed strong support for the proposed changes to payment policies for skin substitutes, which will address waste and abuse related to wound care. NAACOS also encouraged CMS to support MSSP by:
|
- Ensuring MSSP has sustainable and predictable financial benchmarking,
- Reducing burden by creating a more reasonable pathway to adoptions of digital quality measurement, and
- Expanding innovation in MSSP.
|
|
|
UPDATED FAQS ON PI FOR ACOS
|
NAACOS recently met with CMS to discuss the new requirement for Medicare Shared Savings Program (MSSP) ACOs to report Promoting Interoperability (PI) and received clarifications on key questions members have raised. As a result, we are providing an updated resource with new frequently asked questions (FAQs). Additional information on this topic is available for members on the NAACOS website: CEHRT Requirements for ACOs.
CMS also indicated that the agency is still developing guidance for ACOs that choose to report PI at the alternative payment model (APM) entity level. NAACOS continues to advocate for CMS to remove this burdensome requirement for ACO participants not subject to the Merit-based Incentive Payment System (MIPS).
|
|
|
|
LAWMAKERS RACE CLOCK TO FUND GOVERNMENT
|
Congress has until September 30 to reach an agreement to extend government funding and several expiring health programs (e.g., telehealth, hospital at home, disproportionate share hospitals, etc.). Republican leaders have proposed a short-term continuing resolution (CR) that would extend funding through mid-November, buying time for lawmakers to negotiate a broader budget deal for the full Fiscal Year 2026. However, the path to a resolution remains uncertain. Disagreements between Republicans and Democrats over including an extension of Affordable Care Act tax credits has raised concerns that Congress may fail to pass the stopgap measure in time, triggering a partial government shutdown.
|
|
|
|
CMS REVISING MSSP ACO PY2024 FINANCIAL AND QUALITY RESULTS
|
On September 9, 2025, CMS alerted MSSP ACO participants of errors in the calculation of Performance Year (PY) 2024 financial reconciliation contained within the unembargoed financial settlement reports they received on August 28, 2025. CMS will be sharing more information in the coming weeks but indicated that less than 2 percent of ACOs will have a negative impact (i.e., lower shared savings payments or higher shared losses). The errors in the settlement are:
|
- Benchmark Year (BY) 2 truncated national assignable expenditures were inadvertently used in lieu of BY3 truncated national assignable expenditures for the aged/dual and aged/non-dual enrollment types. Each enrollment type is risk adjusted to represent the final Accountable Care Prospective Trend (ACPT) portion of the blended update factor for that enrollment type.
- Calculation of untruncated national assignable expenditure values used for national and regional growth rates for each benchmark year, as well as the national growth rates for BY3 to the performance year.
|
ACOs are anticipated to receive unembargoed report packages by late September/early October in the Data Hub in ACO-MS. NAACOS was excited to see the continued year-over-year success of ACOs, which we do not expect to change with the revised results. For more information, please see the NAACOS statement and stay tuned for the release of the final PY2024 reconciliation results.
|
|
|
RURAL HEALTH FUND APPLICATIONS ARE OPEN
|
CMS has opened applications for $50 billion Rural Health Transformation Program that was included in the One Big Beautiful Bill Act (OBBBA). The program will focus on preventative health, sustainable provider access, workforce development, innovative care models, and the utilization of emerging technologies to improve care delivery. States will have until November 5 to apply. CMS expects to announce funding levels for states by the end of the year. Read the news release and register to attend an applicants’ webinar on September 19 or September 25. NAACOS is interested in hearing from our members on how you are working with states on applications for these funds; reach out to [email protected] to share.
|
MAHA REPORT AND STRATEGY EMPHASIZES CHILDHOOD DISEASE PREVENTION
|
The Make America Healthy Again (MAHA) Commission released the Make Our Children Healthy Again Report and Strategy. With a focus on childhood chronic diseases, the plan outlines 120 initiatives, including four directing CMS to collaborate with state Medicaid and Children’s Health Insurance Program (CHIP) programs on quality measurement, prior authorization for prescriptions, and wellness initiatives.
|
CMS INNOVATION CENTER POSTS EVALUATION REPORTS
|
CMS ANNOUNCES IDEA CHALLENGE TO COMBAT FRAUD
|
CMS is hosting two in-person events in November to bring together experts with diverse backgrounds to combat fraud and enhance the security of health plan identifiers (IDs). At the conclusion of each event, participant groups will pitch their concepts to CMS, and the selected winners will have their concepts published. Interested participants must submit a form by September 26, 2025. Applicants selected for attendance at each event will be notified by mid-October.
|
|
|
|
LAST CHANCE TO REGISTER FOR TODAY’S 12:30 PM ET PARTNER CALL
|
NAACOS Partners! Join us TODAY 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! Don’t miss this chance to fully utilize the benefits of your NAACOS partnership.
This meeting is only open to Partners.
|
NEW TEAM DEEP DIVE ROUNDTABLE BEGINS SEPTEMBER 24
|
The Transforming Episode Accountability Model (TEAM) is a mandatory bundled payment model that will begin January 1, 2026, and run through December 31, 2030. To support members in this model, NAACOS is forming a TEAM Deep Dive Roundtable. Topics will include model implementation, challenges, strategies, and best practices for model execution. Register now!
|
|
|
NEW MEDICAID WEBINAR IN NAACOS ARCHIVE
|
A new archived webinar spotlights Medicaid program design and structure, contracting best practices, and novel partnerships by NAACOS member Essentia Heath. We’re interested in spotlighting other successful approaches for Medicaid partnerships. Reach out to Diwen Chen if you’d like to be featured.
|
|
|
FALL CONFERENCE NEXT MONTH — REGISTER TODAY
|
Connect and learn at the Fall 2025 Conference on October 8-10 in Washington, D.C.! The agenda features expert-led sessions providing real world value-based care strategies, as well as networking opportunities for participants, speakers, and vendors to share ideas, explore partnerships, or gain insider insights. Agenda highlights include:
|
- Thursday Plenary features Dr. Pippa Shulman of American Academy of Home Care Medicine and DispatchHealth, a pioneer in delivering acute care in the home
- Networking lunch on Thursday connects attendees, speakers, and industry leaders in a relaxed and engaging setting
- Health Care Investor Roundtable on Friday morning moderated by Henish Bhansali of Medical Home Network brings together leading voices in health care investment
|
Registration is open and will remain open until the conference. Can’t attend in person? Register for the live webcast. As always, the entire conference will be recorded. All participants, both in-person and virtual, will be able to view any sessions they missed live for six months following the conference.
|
FINAL REGIONAL MEETINGS IN 2025: VIRTUAL SOUTHEAST, IN-PERSON SOUTHWEST
|
|
|
Register today for the Southeast virtual meeting on September 26, 1:00 to 5:00 pm ET. 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.
In addition, we are excited to announce an in-person meeting for the Southwest Region on November 6 from 8:00 a.m. to 3:00 p.m. in Phoenix, AZ. Registration is now open. If you are interested in speaking or shaping this meeting’s agenda, email [email protected].
Regional events are open to NAACOS members, non-member ACOs, and value-based care providers. Virtual events are complimentary. 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. These events are not open to non-sponsoring business partners.
|
- Inside Health Policy recently reported on criticisms of the Wasteful and Inappropriate Service Reduction (WISeR) Model, mostly from democratic lawmakers, and CMS Innovation Center Director Abe Sutton’s defense of the model’s goals.
- Articles from Wiley and McKinsey feature strategic approaches and frameworks for engaging specialists in care redesign, specialty care models such as episodes of care, and evolving accountable care environments. McKinsey’s latest analysis reveals top specialty areas such as women’s health and behavioral health, followed by oncology, orthopedics, cardiology, and nephrology.
- According to a Modern Healthcare article, the dual-eligible population is about 13 million now and expected to grow by about 6 percent annually through 2028. This makes the duals market increasingly important for health plans, but engaging and retaining this population is challenging due to their complex health and social needs.
|
|
|
|
