Senate GOP Reconciliation Negotiations Continue. Senate Republicans have been negotiating changes to the One Big Beautiful Bill Act, Republicans’ reconciliation package. Senate Majority Leader John Thune (R-SD) is facing conflicting calls from segments of his party to alleviate Medicaid cuts and to increase savings. According to the Congressional Budget Office’s (CBO) latest analysis, the Medicaid provisions in the reconciliation text would reduce the deficit by $864 billion, and the bill, in total, would increase the number of uninsured people by 10.9 million over the next decade. The House-passed bill includes a Medicare physician fee schedule payment provision that provides a favorable Medicare Economic Index update for one year but does not include an advanced alternative payment model incentive and would repeal the split conversion factor. As a reminder, the split conversion factor was enacted to provide long-term incentives for accountable care participation. A4H has been working with stakeholders to modify this provision in the Senate to restore accountable care incentives. The Senate Finance Committee is currently expected to release their legislative text by early next week.

Hill Briefing on Accountable Care for Complex Populations. A4H, in collaboration with the Complex Care Alliance the Coalition to Transform Advanced Care (C-TAC) and other partners, held a congressional briefing on accountable care for complex populations. Panelists discussed lessons learned from participating in the High-Needs Track of ACO REACH, how care has improved for vulnerable, home-bound populations, and cost savings from these models. Following the panel discussion, A4H members met with House and Senate offices to discuss the need for continuity for the ACO REACH High Needs Track beyond 2026. View the Complex Care Alliance policy paper containing recommendations for the future of High Needs ACO REACH here.

MedPAC Releases June 2025 Report to Congress. The Medicare Payment Advisory Commission (MedPAC) released its June 2025 Report to Congress, which reports on the Medicare fee-for-service (FFS) payment systems, the Medicare Advantage (MA) program, and the Medicare prescription drug program (Medicare Part D). Consistent with recommendations from previous years, the Commission stated Congress should replace the current law updates to the physician fee schedule with an annual update based on a portion of the growth in the Medicare Economic Index (MEI). While MedPAC did not address how the advanced APM bonus should be structured, the Commission stated that some form of bonus may be an important component of payment for clinician services as policymakers seek to improve APM design and performance.

Listening Session on the Health Technology Ecosystem RFI. The Administration hosted an in-person listening session in Washington, DC to discuss the RFI and ways to use health technology innovations to enhance patient care and promote efficiencies in the health care system. Secretary Kennedy and CMS Administrator Oz, as well as several other political leaders spoke at the event, highlighting the opportunity to modernize and streamline systems to improve population health. A4H was thrilled to be invited to participate in this event, which included dedicated discussions on the intersection of technology and value-based care. A4H will be responding to the Administration’s RFI. Responses are due on Monday, June 16.

HHS FY26 Budget Released. President Trump released the fiscal year (FY) 2026 President’s Budget Request in late May, proposing a significant reorganization of the Department of Health and Human Services (HHS) and its subagencies, as well as an overall 25 percent cut in funding, $31.4 billion less than enacted in FY25. The core elements of HHS’s reorganization plan are the creation of two new subagencies: the Administration for a Healthy America and the Administration for Children, Families, and Communities; streamlining the 28 operating divisions into 15; and closing five of the “most costly” regional offices. The CMS Congressional Justification document emphasizes value-based care as a strategic priority, and discusses the Medicare Shared Savings Program, Quality Payment Program, and select CMS Innovation Center models. The President’s Budget Request is a recommendation and articulation of priorities; congressional appropriators will determine the final funding levels and accompanying policies.

A4H Responds to FY 2026 IPPS Proposed Rule. A4H submitted comments on the FY 2026 Hospital Inpatient Prospective Payment System (IPPS) proposed rule, which included recommendations related to the new Transforming Episode Accountability Model (TEAM) and the shift toward digital quality measurement.

A4H Responds to Deregulation RFI. In response to CMS’s RFI included in the CY 2026 IPPS proposed rule—part of the Trump Administration’s push to reduce regulatory burdens—A4H urged CMS to streamline rules that hinder the success of accountable care.

Value-Based Care Improves PCP Access. agilon health released new research in the May 2025 issue of Health Affairs Scholar. Using claims data, researchers compared two groups of primary care providers (PCPs) with Traditional Medicare (TM) patients in their panels: one group in a value-based care (VBC) model and one in fee-for-service (FFS). VBC PCPs saw eight more new TM patients per year compared to the matched cohort of physicians, and PCPs shifting to VBC kept their practices open to new TM patients for an average of 0.7 months longer per year.

Oak Street Health Highlights Importance of Primary Care. Oak Street Health released a new white paper highlighting the impact of their advanced primary care model on patients. Oak Street’s innovative model integrates physical, behavioral, and social care designed to provide their patients with personalized support and services to keep them healthy and out of the hospital. Oak Street’s approach resulted in a 44 percent reduction in hospital admissions compared to Medicare benchmarks, while also enhancing patient satisfaction.

Save the Dates for our Upcoming Double Click Meetings. Our in-person quarterly meetings are for policy-focused audiences in Washington, DC. Each meeting will be held at the Kaiser Center for Total Health (700 2nd St, NE, Washington, DC) from 11am to 2pm ET. Details to follow.

• Tuesday, September 30
• Tuesday, December 9