New Legislation to Improve Quality Reporting. This week, Reps. Vern Buchanan (R-FL), Jimmy Panetta (D-CA), and Dan Crenshaw (R-TX) introduced the Healthcare Efficiency Through Flexibility Act. The bill delays the implementation of the Centers for Medicare and Medicaid Services’ (CMS) proposed rule requiring accountable care organizations (ACOs) to transition to electronic Clinical Quality Measures (eCQMs). A4H worked closely with Rep. Buchanan as he developed this legislation. A4H’s support notes that while eCQMs may eventually enhance reporting and data sharing to improve patient care, organizations need more time to ensure a smooth transition.

President Trump Returns to the White House. On January 20, President Donald Trump was inaugurated as the 47th President of the United States. Immediately following the ceremony, President Trump issued dozens of executive orders and other administrative actions related to immigration, energy, the federal workforce, and other areas. As expected, President Trump’s “Day One” – and week one – activity has been fairly light on healthcare. President Trump began the process of withdrawing from the World Health Organization and rescinded several executive orders issued by President Joe Biden related to COVID-19, the Affordable Care Act, Medicaid, and prescription drugs. A4H will continue to monitor the Administration’s accountable care activity and looks forward to engaging with the Administration to advance accountable care policy.

CMS Announces Growth in Accountable Care Participation. CMS published a fact sheet on accountable care initiatives, including data from the ACO REACH Model, the ACO Primary Care Flex Model, and the KCC Model. As of January 2025, 53.4 percent of traditional Medicare beneficiaries are in an accountable care relationship with a provider – a 4.3 percentage point increase from January 2024. Other data highlights include 55 new ACOs accepted into the Medicare Shared Savings Program and 173 renewing or reentering ACOs, serving 11.2 million beneficiaries; 103 ACOs continuing participation in the ACO REACH Model, serving 2.5 million beneficiaries; 78 Kidney Contracting Entities and 15 CMS Kidney Care First Practices continuing participation in the KCC Model, serving 240,000 beneficiaries; and 24 ACOs in the newly-launched ACO PC Flex Model, serving 349,000 beneficiaries. A4H is pleased to see the continued expanded reach of models that promote better care at a lower cost.

CMS Discusses “Successor Models” and Scaling Model Successes in Blog Post. The Innovation Center’s work testing innovative payment and service delivery models is supported by several tools, two of which CMS identifies in the blog post: successor models, or new models building on prior models, and scaling pathways, or how CMS implements successful strategies and systems from models into Medicare and Medicaid. CMS highlights the history of certain iterative models, including the first kidney-specific ACO model, the Comprehensive ESRD Care Model (CEC), and its successor models, the ESRD Choices and Kidney Care Choices (KCC) Models. CMS also distinguishes four scaling tools, including (1) incorporating model elements into Medicare through rulemaking, (2) adopting model features through legislation, (3) successor models, as discussed earlier, and (4) broad adoption of certain model features into the private sector, such as the health-related social needs tool developed by CMS for the Accountable Health Communities Model. A4H will continue to engage with CMMI on model design and to advocate for the full adoption of strategies that create continuity for model participants, particularly when model elements are demonstrating success and improving care and lowering costs.

CMS Proposes Increase in MA Plan Payments. In the Calendar Year (CY) 2026 Advance Notice for the Medicare Advantage (MA) and the Medicare Part D Prescription Drug Programs (CY2026 Advance Notice), CMS proposed an average increase of 4.33 percent (2.23 percent when you remove the risk score trend factor) in MA payments to plans. The Advance Notice also includes policies regarding Part D Redesign under the Inflation Reduction Act, the completion of the three-year phase-in of a Part C Risk Adjustment Model, and updates to the Star Ratings program. The final version of the proposal is scheduled to be released no later than April 7; some stakeholders will likely push for a larger rate increase, given President Trump’s past statements of support for MA. Earlier this week, A4H hosted a members-only call on the Advance Notice to discuss implications of this notice and the broader MA environment.

Paragon Releases Analysis of MA and ACOs. In a recent policy brief, Paragon Health Institute Senior Policy Analyst Joe Albanese discusses the structural differences and policy challenges facing Medicare Advantage (MA) and accountable care organizations (ACOs) compared to traditional Medicare (TM). The brief highlights how MA and ACOs can help the transition to accountable care away from fee-for-service. In the analysis, Albanese noted that policymakers could consider additional ways to improve both programs, such as through more credible and savings-focused benchmarks, less gameable risk adjustment, and less burdensome quality measures.

Accountable for Health is pleased to work with stakeholder organizations to support Health Care Value Week, a week of action to support value-based care education and advocacy. We would like to invite our members and friends to participate in the following Value Week events (please note separate registrations):

• Register for A4H In-Person Value Week Event, February 25. A4H will host a day-long in-person conference in conjunction with Health Care Value Week in Washington, DC. Hear Congressional, Administration, community and provider perspectives on accountable care. Sessions include state approaches to affordability, data and health information technology, and clinical perspectives to advance health care delivery. This event is complimentary and open to members and non-members of Accountable for Health. You can register and view the full list of speakers on our website. An agenda will be posted shortly.
• A4H In-Person Innovation Showcase, February 26. A4H and the Innovation Caucus will host a showcase at the Rayburn House Office Building from 11am to 1pm. Attendees can walk through the Rayburn foyer and visit A4H member displays to hear first-hand their approaches to accountable care. Register here.
• Virtual Value-Based Payment Summit, February 24-28, the Virtual Health Care Value week conference is a week-long series of sessions featuring speakers on a variety of value-based care topics. You can register and view the full list of sessions on their website.