Bipartisan Bill Establishes Permanent Full-Risk ACO Program
Measure Translates Proven Innovation Center Models into Stable, Predictable Option
Washington, D.C. (March 26, 2026)
Accountable for Health, an advocacy organization of more than 60 providers, payers, and innovators founded to champion accountable care, today applauded Reps. Claudia Tenney (R-N.Y.) and Brad Schneider (D-Ill.) for introducing bipartisan legislation to establish a permanent, full-risk accountable care organization program in Medicare.
The legislation builds on more than a decade of successful Center for Medicare and Medicaid Innovation (CMMI) accountable care organization models that have demonstrated improved outcomes and lower costs for Medicare beneficiaries.
“For 15 years, accountable care organizations have proven that when providers are accountable for cost and quality, patients receive better care and Medicare saves money,” said Mara McDermott, CEO of Accountable for Health. “Congress now has the opportunity to move from time-limited demonstrations to a permanent, full-risk pathway in traditional Medicare that provides certainty and predictability.”
CMMI has tested full-risk accountable care models, including ACO REACH, Direct Contracting, Next Generation, and Pioneer ACO models. These models have repeatedly generated cost savings and improved health outcomes for Medicare beneficiaries.
CMMI ACOs differ from the Medicare Shared Savings Program (MSSP) in key aspects. The new bill would codify these features that have proven effective, including:
- Full financial risk for participating organizations
- Options for capitated payment
- Ability to enter into unique payment arrangements with downstream providers
- Concurrent risk adjustment tailored to patient populations
- Streamlined quality measurement focused on outcomes and patient experience
- A dedicated complex care track for beneficiaries with six or more chronic conditions
Under the legislation, CMS would establish both Standard and Complex Care tracks, ensuring providers caring for the most medically complex Medicare beneficiaries have a stable platform to deliver coordinated, individualized care.
The legislation comes as CMS continues to refine its accountable care portfolio, including the upcoming Long-Term Enhanced ACO Design (LEAD) Model. A4H emphasized that the new bill complements these efforts.
“LEAD is an exciting new development and we strongly support the Innovation Center’s direction for offering a 10-year model,” McDermott said. “We believe there is sufficient evidence now to justify making these offerings a permanent payment option in the future.”
By embedding a full-risk model in law, Congress would provide continuity for high-performing organizations currently participating in Innovation Center models, while creating a durable glidepath for others seeking to take on greater accountability.
“Accountable care is no longer an experiment and is a proven model for improving quality and addressing Medicare’s affordability challenges,” McDermott added. “We are grateful to Reps. Tenney and Schneider for their bipartisan leadership in strengthening traditional Medicare and ensuring accountable care remains a permanent option for providers and beneficiaries alike.”
Contact:
Mara McDermott, CEO of Accountable for Health
mmcdermott@accountableforhealth.org
About Accountable for Health
Accountable for Health (A4H) is a 501(c)(4) national advocacy and policy analysis organization accelerating the adoption of sustainable, effective accountable care that improves health care quality and outcomes and lower costs. We represent a broad, diverse group of accountable care stakeholders working to improve the way health care is delivered to people across the county, across various payers, programs, and delivery models. A4H provides advocacy, research, and education to improve outcomes and patient experiences while lowering costs.
For more information, visit https://accountableforhealth.org/. Follow us on LinkedIn and Twitter (@acct4health). ###
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