NAACOS COMMENTS ON PROPOSED MANDATORY MODEL

CMS continues to leverage mandatory hospital bundled payment models as an approach to improve quality and reduce costs in specialty care. In the FY 2027 Inpatient Prospective Payment System proposed rule, CMS proposes to expand the Comprehensive Care for Joint Replacement Model. The model was previously tested 2016–2024 in select geographic regions and demonstrated to lower costs while maintaining quality. Notably, the expanded model test is indefinite, with no end date, and would apply to all geographic regions, capturing most hospitals. NAACOS submitted comments in support of conceptually expanding the model; however, we raised significant concerns about long-term sustainability, financial pressure, and evolving care delivery patterns. We will continue to work with the Administration to address our concerns with the model. Additionally, we are here to support our members with operating in the model. Join our Specialty Care roundtable to stay part of the conversation.

MEDICARE PAYMENT REFORM INCHES FORWARD

Physician payment reform and continuing incentives for adopting value remains a congressional priority, with a recent Energy and Commerce Hearing on MACRA and the House Republican and Democratic Doctors Caucuses bill expected in June or July. NAACOS continues to advocate for our priorities for payment reform, which include:

• Strengthening financial incentives that drive participation in alternative payment models (APMs);

• Updating physician payment to account for inflationary pressures; and

• Ensuring payment models support long-term sustainability and innovation.  

If you’re engaged with your Members of Congress or would like to be, contact Robert Daley.

HOSPITAL-SPECIFIC TEAM REPORTS AVAILABLE

The American College of Surgeons has created hospital-specific TEAM performance reports for more than 2,000 facilities based on modeling developed with the Institute for Accountable Care. NAACOS is working with ACS to make these reports available to members for free. These reports show how your hospital would have performed had the model been in place for 2024, including the financial impact of complications and emergency department visits. Request your report today. 

INTEROPERABILITY AND PRIOR AUTHORIZATION

NAACOS has made available draft comments in response to the CMS and ONC proposed rule on Interoperability Standards and Prior Authorization for Drugs proposed rule. NAACOS supports CMS’ proposal to extend interoperability and prior authorization improvements and feels that these changes would reduce administrative burden, improve care coordination, and help ACOs better manage total cost of care. Members can access the draft comments and share feedback, or use the language in their own responses, due June 15.

GOVERNMENT FUNDING TAKES CENTER STAGE

Lawmakers are beginning work on FY 2027 spending bills, launching the annual appropriations process. Congress has until September 30 to extend government funding. A short-term funding extension past the mid-term elections is likely. Additionally, Republican leaders in the House and Senate are discussing a potential third reconciliation package, which allows the majority party to pass legislation without support of the minority, that could include changes to health care programs and other federal spending priorities.

HOUSE HEALTH FUNDING BILL TAKES ON WISeR AND SKIN SUBS

Bipartisan opposition to the CMS Innovation Center’s WISeR model is growing on Capitol Hill. The House Appropriations Committee unanimously adopted an amendment to the FY 2027 HHS spending bill that would prohibit funding for implementation of the model and require CMS to report back on the impact of changes to reimbursements for skin substitutes. The bill has a long path ahead as it will need to pass the House and be reconciled with the Senate’s pending version.

NEW QPP RESOURCES AND PERFORMANCE DATA AVAILABLE NOW

CMS recently published several new resources under the Quality Payment Program (QPP) resource library relevant to ACOs and participant providers subject to MIPS, including:

• PY 2026 Medicare CQM Reporting by MSSP ACOs Resource

• PY 2026 eCQM Implementation Checklist and Resources

• PY 2026 MIPS Promoting Interoperability Hardship Exception Application Guide

• PY 2026 MIPS Extreme and Uncontrollable Circumstances Exception Application Guide

• PY 2024 QPP Participation and Performance Results At-A-Glance

Clinician participation in APMs continues to increase; the PY 2024 QPP performance results showed a 14.05 percent increase in the number of clinicians who achieved Qualifying APM Participation (QP) status and a 50.34 percent increase in Partial QPs. Additionally, MIPS APM participants achieved significantly higher MIPS final scores (92.95 average) than non-APM participants (83.30 average). The maximum MIPS payment adjustment for a perfect MIPS final score (100 points) is 1.05 percent.

BEAT THE RUSH:  REGISTER EARLY FOR THE FALL CONFERENCE

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 now posted and will cover new models, network redesign, behaviorial health, rural health transformation, specialist engagement, quality reporting, and more. Register early and save!

The exhibit/sponsor program applications for the fall conference are now being accepted. Reserve your space today! Please note, all sponsorships and exhibit space are on first-come first-served basis, and space is assigned in the order we receive applications.

SEE YOU NEXT WEEK AT MID-ATLANTIC REGIONAL MEETING

Not registered and want to join this networking and learning opportunity next week in NYC?  Join NAACOS and our meeting sponsor Persivia on June 17 for an exclusive in-person gathering of the Mid-Atlantic Region’s most influential value-based care leaders. Sessions include Raising the Bar: The Evolution of Value-Based Care in New York, Hear from Health Plan Leaders on What Works and What Doesn’t, Alphabet Soup: Understanding New Models, Technology Strategies, Goals of Care Progress and Limitations at the System Level, and much more. Registration: $50 for NAACOS members; $250 for nonmembers.

MID-WEST & NORTHEAST REGIONAL MEETING AGENDAS AVAILABLE

We look forward to welcoming members and their partner organizations from the Midwest region on July 16 in Milwaukee, WI, sponsored by Innovaccer, and from the Northeast region on July 28 in Providence, RI, sponsored by Reveleer.

Review the agendas and register today to join discussions on some of health care’s most pressing topics, including post-acute care strategies, policy, and regulatory updates from the NAACOS Policy Team, technology and AI innovation, and more. These meetings provide valuable opportunities to connect with peers, share insights, and stay informed on the latest trends shaping accountable care.  Also, be on the lookout for registration information in our next newsletter on a Transitions of Care Summit convening in Providence, RI, on July 29, for ACOs and their hospital, SNF, home health, and other post-acute providers to start the discussion of transitions of care management in a world of waivers and complex payment rules.

NEW WEBINAR ON ACO LEAD AND MSSP FINANCIAL REQUIREMENTS

Join Sparx and ACO leaders at VillageMD on June 23 at 2:00 pm ET for a discussion on best practices for navigating the financial requirements of ACO LEAD and MSSP in PY27, with a focus on surety bonds, stop-loss strategies, and actuarial insights. The session will highlight how Sparx can help ACOs unlock tens of millions of dollars in capital through a 0 percent collateral surety bond solution, enabling organizations to continue investing in their ACO programs while meeting CMS Financial Guarantee requirements.

Learn how Sparx’s actuarially driven, performance-based underwriting approach differs from traditional collateral-based models, allowing qualifying ACOs to secure surety bonds without significant restricted cash or balance sheet support. Sparx will also cover CMS stop-loss mechanics, the impact of budget neutrality, and how external stop-loss markets can create strategic and economic advantages for certain organizations. Finally, Sparx will share how its proprietary actuarial platform and low-lag national datasets help ACOs evaluate risk, benchmark performance, assess capital needs, and prepare for PY 2027. The webinar will include practical market insights, a real-world case study with a top-performing ACO, and actionable strategies for ACOs participating in LEAD and MSSP. Register today.

JOIN INNOVACCER FOR VIRTUAL EVENT, CONTEXT: JUNE 23–24

Context: The Healthcare Autonomy Conference is a two-day virtual summit on June 23–24, presented by NAACOS business partner Innovaccer, built for ACO and value-based care leaders navigating the shift from AI that surfaces insights to AI that acts on them. Across five tracks, 50+ sessions, and live Agentic AI Workshops, thousands of health care leaders will explore how AI with the right clinical, payer, and regulatory context can close risk gaps, execute quality measures, and drive population health performance before the window closes. Register here.

• The Medicare Payment Advisory Commission (MedPAC) will release its June Report to Congress in the coming days. Additionally, The Government Accountability Office (GAO) announced the appointment of the Chair, Vice Chair, and two new members to the Medicare Payment Advisory Commission (MedPAC).

• A recent Health Affairs study examines the growing role of third-party convener firms and finds that conveners, by aggregating providers, offering infrastructure, and managing risk, are enabling participation at scale, but may also shift where savings accrue within the system.

• A recent JAMA study highlights the rapid growth of the “payvider” model, in which hospital systems expand into insurance by offering provider-sponsored health plans. The findings show that from 2018 to 2023 more hospitals have integrated financing and care delivery as they take on greater financial risk in value-based payment models.