Government Funding Update. House Republicans advanced their short-term funding bill that funds the government through November 21. This package extends expiring health provisions, including Medicare telehealth flexibilities, funding for Community Health Centers, and a delay of Medicaid Disproportionate Share Hospital cuts through November 21. Democratic leadership is insisting on a bipartisan compromise and has introduced their own competing short-term funding bill that would run through October 31, which includes an extension of the Affordable Care Act (ACA) enhanced premium tax credits and reverses some of the recent Medicaid changes from the Republican led One Big Beautiful Bill Act. The Senate is scheduled to vote on both the House-passed funding bill and the Democrat led bill on Friday; both are expected to fail. If a deal cannot be reached by September 30, some government operations will shut down.

House Ways and Means Advances Bill to Reduce Burdens on ACOs. The House Ways and Means Committee advanced several health care bills this week, including H.R. 5347, the Health Care Efficiency Through Flexibility Act, a bipartisan bill to streamline quality reporting for ACOs in the Medicare Shared Savings Program (MSSP). The Committee also considered other bills to increase seniors’ access to early detection screenings for cancer, in-home care through the Hospital-at-Home program, and breakthrough medical technology. This activity highlights the Ways & Means Committee’s interest in advancing low-cost legislation on topics with the potential for significant impact for Medicare beneficiaries and the healthcare system, including accountable care. Our statement on H.R. 5347 is available here. We expect these bills could be considered for action at the end of the year, depending on the broader health care legislative landscape. A4H will continue to work with the Committee and lawmakers to drive legislative solutions for accountable care.

CMS Highlights Accountable Care in Rural Health Transformation Program Materials. The application for the Rural Health Transformation (RHT) Program, the five-year, $50 billion rural health fund created by the One Big Beautiful Bill Act, opened on September 15. States can apply by November 5 to be eligible for funding during fiscal years 2026-2030. CMS emphasizes the RHT Program is intended to “transform the healthcare delivery ecosystem” in rural communities and highlighted innovative care and payment models as one of five strategic goals for the fund. CMS recommends that states consider using funding from the RHT Program to “develop and implement payment mechanisms incentivizing providers or Accountable Care Organizations (ACOs).” A4H encourages members to connect with state-level policymakers who are preparing applications. A4H members can join us at our upcoming in-person meeting in DC on September 30 for further discussion of this topic.

A4H Submits Comments on Physician Fee Schedule. Our comments strongly support CMS’s proposal to change reimbursement for skin substitutes and recommended a payment rate of $65 per square centimeter; supported a more rapid transition to two-sided risk in MSSP; supported the proposed mandatory ambulatory specialty model; and applauded proposals to strengthen primary care. Specific to skin substitutes, A4H, along with several allied organizations, also submitted a letter to CMS in support of the proposal, featured in the Washington Post.  A4H and its members continue to weigh in with Congress and the Administration in support of the proposal in the PFS and to urge action to ensure that accountable care providers are not inappropriately held accountable for fraudulent claims.

PTAC Meeting Focuses on Data and Health IT to Empower Consumers and Support Providers. The Physician-Focused Payment Model Technical Advisory Committee (PTAC) held a public meeting on September 8 and 9. PTAC held sessions on improving data infrastructure, the availability and utility of tech tools to inform patients about their health and health care, how shared data can enable joint decision-making between patients and providers, enhancing secondary prevention and engaging patients with chronic diseases, and payment model and benefit design reform to empower patients. A4H submitted comments ahead of the PTAC meeting in response to their Request for Input (RFI). We look forward to continued engagement with stakeholders and policymakers to demonstrate the impact of coordinated patient-centered care.

Health Affairs: ACO REACH 2023 Performance Results Indicate a Pathway to Sustainable Accountable Care. In this article, the authors highlight the role of ACO REACH in laying the groundwork for the “next iteration” of accountable care, beyond MSSP. Their analysis examines the model’s progress and the relationship between performance metrics and evaluation findings. The authors also identify policy considerations to support ongoing model implementation and opportunities for CMS to enhance transparency, support adoption of value-based care, and advance equity in ACOs. Evaluation findings include that maturation in the model drives increases in savings over time, which the authors cite as a key reason CMS should provide clarity on the future of the model.

Bipartisan Policy Center: Toward Value and Sustainability: Medicare Part B Physician Payment and Related Reforms. This report by the Bipartisan Policy Center (BPC) considers reforms to Part B physician payment. Recommendations include incentivizing participation in APMs, including reforming the Medicare PFS to ensure adequate valuation and reimbursement for high-value services; reducing fragmentation and complexity through improvements to APM model design and addressing “structural limitations” within MSSP; and reducing administrative burden by streamlining EHR and quality measurement requirements. BPC acknowledges that some of the reforms will require investment from the federal government—for example, to support practices with limited resources as they transition to APMs.

A4H Double Click on Accountable Care, September 30. This in-person quarterly meeting is for our policy-focused members. Members will receive an update on the CMS Innovation Center models and CMS activities, and the One Big Beautiful Bill Rural Health Transformation Program. For more information contact srobinette@accountableforhealth.org.

Congressional Briefing on Kidney Care, October 21. Join Accountable for Health (A4H) and the Coalition to Transform Advanced Care (C-TAC) for a hill briefing with experts in health care, policy, and patient advocacy on “Improving Kidney Care with Innovative Payment and Delivery Models.” This session will include conversations about the CMS Innovation Center (CMMI) and the Comprehensive Kidney Care Contracting (CKCC) model to improve health outcomes and lower costs. The briefing will be held at the Rayburn Building, Room 2060 from 12pm to 1pm. Register here.

Speakers Include:

• Brendan Fulmer, Vice President, CareBridge
• Liz Fowler, Former Director, CMMI
• Scott Lloyd, Chief Development & Strategy Officer, Evergreen Nephrology
• Misha Palecek, CEO, VillageHealth
• Chris Riopelle, Co-Founder, Strive Health
• Gary Singer, MD, President, Renal Physicians Association