CMS’ GEO AHEAD MODEL LEAVES UNANSWERED QUESTIONS
The AHEAD model is a state-based CMMI model that aims to slow spending growth across all payers while improving quality through hospital global budgets and enhanced primary care payment. Six states are working to launch the model over three cohorts, with Maryland beginning this year. The model builds on the Maryland Total Cost of Care Model but adds geographic attribution to align unattributed beneficiaries to an ACO.
While NAACOS supports the concept of the Geo AHEAD model, we have serious concerns about its feasibility that we have shared with CMS and highlighted in our latest Health Policy Unpacked video on LinkedIn.
If you are in one of the AHEAD states (Maryland, Connecticut, Hawaii, Vermont, Rhode Island, and New York), reach out to [email protected] to be included in our ongoing discussions with CMS. |
• • •NAACOS Advocacy |
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HOUSE PASSES BILL TO REDUCE ACO REPORTING BURDENS
Last week, the House of Representatives unanimously passed the Health Care Efficiency Through Flexibility Act (H.R. 5347). This NAACOS-supported legislation will direct CMS to pilot a more practical approach to digital quality reporting. We are hopeful the bill will encourage CMS to make meaningful changes in the upcoming Medicare Physician Fee Schedule, and we will be working with our Senate champions to continue advancing the bill.
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• • •Congressional Updates |
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LOOKING AHEAD ON PHYSICIAN PAYMENT REFORM
Congress is out of session for the Fourth of July Recess. Work on health care policy continues behind the scenes as NAACOS and other stakeholders are eagerly awaiting the release of the House Republican and Democratic Doctors Caucus legislation to reform Medicare physician payment. NAACOS has been closely engaged with the caucus throughout the process and will provide updates for members once the legislation is released.
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• • •Administration Updates | CY 2027 OPPS AND ASC PROPOSED RULES RELEASED
On July 2, CMS released the Calendar Year (CY) 2027 Hospital Outpatient and Prospective Payment System (OPPS) and Ambulatory Surgery Center (ASC) Payment System proposed rule. CMS proposes that hospitals that meet their outpatient quality reporting requirements will receive a 2027 payment increase of 2.4 percent, resulting in a $9.5 billion increase over 2026. Likewise, ASCs will receive a 2.4 percent increase in payments resulting in an additional $520 million over 2026. Other notable provisions of the rule include:
Continuing to phase out of the Inpatient Only (IPO) list. This is the second of a three-year phase out. Expanding site-neutral payment policies for excepted off-campus provider-based departments (PBDs) to include imaging without contrast services. Changing payment for 340B acquired drugs from ASP plus 6 percent to ASP minus 33.4 percent. In 2018, CMS finalized a similar policy that was later reversed by the Supreme Court. The court determined that the payment cuts were unlawful because cuts were implemented without first conducting a mandatory survey of hospital acquisition. The current proposal was informed by a survey conducted from January 1-April 7, 2026. Coordinating an RFI on strengthening hospital transparency data. |
QUALITY PAYMENT PROGRAM UPDATES
Quality Payment Program (QPP) exception applications are available through December 31, 2026, at 8 pm ET. As a reminder, CMS finalized new Extreme and Uncontrollable Circumstances (EUC) policies for MSSP ACOs that are impacted by a cyberattack. Affected ACOs must submit a MIPS EUC exception application at the APM entity in order to receive relief from quality reporting requirements and have any shared losses mitigated under the policies. Additional details can be found on the QPP website.
The 2027 self-nomination period for Qualified Clinical Data Registries (QCDRs) and Qualified Registries is open through September 1. ACOs and other MIPS reporters do not need to nominate themselves in order to report MIPS via a QCDR or qualified registry. Additional information can be found in the QPP resource library. |
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Education Opportunities |
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SAVE ON FALL CONFERENCE: LOCK IN HOTEL & REGISTRATION NOW
Register today for the Fall 2026 Conference, taking place October 14–16 in Washington, D.C. The conference will feature a robust lineup of plenary and breakout sessions designed to help members lead high-performing accountable care programs while building the skills and knowledge needed for the future. This year’s agenda will offer exclusive insights from top CMS officials, highlight emerging strategies to drive success in population health, and showcase proven approaches with lasting impact in our rapidly evolving industry. The preliminary agenda is available and will cover new models, network redesign, behavioral health, rural health transformation, specialist engagement, quality reporting, and more. Register early and save!
Don't forget to reserve your hotel room at the Marriott Marquis. The discounted rate is $359.00 per night plus taxes and fees. This discounted rate is good through August 31, 2026, or until the block is full. The hotel will not release additional rooms to us at the discounted rate. Please book early.
| NEW TRANSITIONS OF CARE SUMMIT
NAACOS will hold a half-day Transitions of Care (TOC) Summit in Providence, RI, on July 29 at the Providence Marriott Downtown from 8:00 am to 1:30 pm ET, following the Northeast Regional Meeting on July 28. This convening looks to bring together ACOs, hospitals, skilled nursing facilities, home health agencies, and other post-acute care providers to explore transitions of care management amid evolving waivers, complex payment rules, and new opportunities for collaboration. Topics will investigate the current state of TOC, how to improve workflows and outcomes, as well as identify how we can work together to advance patient and financial outcomes in this space. We invite our ACOs to bring the hospital staff you work with on hospital and emergency department discharge protocols and key staff from the post-acute admissions and administration teams to discuss these topics as a workgroup.
If you would like to join us for this event, email Karen Fettterolf, NAACOS education manager.
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LEARN FROM PEERS AT SUMMER REGIONAL MEETINGS
Register now for the remaining Summer Regional Meetings, offering opportunities to connect with peers, hear from industry experts, and discuss the latest strategies shaping value-based care. Join us in person or virtually at one of these upcoming events:
Across all four meetings, attendees will explore the summer’s hottest topics including:
Utilization and Resource Deployment Alphabet Soup: Understanding New Models Care Innovation & Clinical Excellence Technology Strategy Post-Acute Collaborations in Value-Based Care
Whether you attend in person or virtually, Summer Regional Meetings provide valuable opportunities to learn from peers, discover innovative approaches, and bring actionable ideas back to your organization. Registration for in-person meeting is $50 for members and $250 for non-members. Virtual meetings are free to all. Only sponsoring business partners may attend both in-person and virtual regional meetings. Register today to reserve your spot.
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What We're Watching |
Nominations are currently open to serve on the Physician-focused Payment Model Technical Advisory Committee (PTAC). Submissions are due by July 13, 2026, and appointments will be announced in October 2026. This AJMC Special Report about the Oncology Care Model (OCM) highlights notes that while the model resulted in more than $600 million in net losses for Medicare, many oncology leaders view OCM as a catalyst for oncology value-based care because it accelerated investments in patient navigation, clinical pathways, care coordination, remote patient monitoring, and proactive symptom management.
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