A4H files comments in response to the Request for Information (RFI) on the Patients First Act. A4H supports the goal to establish a stable, predictable Medicare physician payment system and believes those reforms should be paired with policies that address the underlying drivers of Medicare spending.
CMS’s 2024 results show that ACO REACH generated nearly $1 billion in net savings while improving quality and supporting better coordinated care for 2.5 million Medicare beneficiaries. This issue brief highlights the model’s growing financial performance, strong results for High Needs ACOs, and continued progress on key measures of patient care.
A4H sent a letter to congressional leaders supporting H.R. 5347, the Health Care Efficiency Through Flexibility Act, praising the bill as a practical step to reduce unnecessary administrative burden on ACOs, preserve quality reporting flexibility through 2029, and support continued participation in value-based care.
A4H’s Kidney Care Coalition outlines a roadmap to strengthen and sustain specialty-focused kidney care models in Medicare. The paper offers policy recommendations to improve stability, expand participation, strengthen accountability, and ensure continued access to value-based kidney care beyond 2027.
A4H’s Kidney Care Coalition partnered with independent actuaries at Wakely to reassess the early financial performance of Medicare’s Comprehensive Kidney Care Contracting Model. The analysis found the model could have generated meaningful net Medicare savings under CMS’s 2026 policy changes, with savings expected to grow as providers gain experience and care transformation efforts mature.
A4H’s Kidney Care Coalition released new resources showing that accountable kidney care is improving outcomes and has stronger savings potential than early evaluations suggest. With the CKCC Model set to end in 2027, CMS should build on this progress by creating a stable, long-term pathway for kidney care providers to continue delivering coordinated, patient-centered kidney care.
A4H files comments in response to the Request for Information (RFI) on Electronic Event Notifications for Value-Based Care and Care Coordination included in the Interoperability Standards and Prior Authorization for Drugs Proposed Rule.
A4H files comments in response to the Fiscal Year (FY) 2027 Hospital Inpatient Prospective Payment System (IPPS) proposed rule, specifically the Comprehensive Care for Joint Replacement Expanded (CJR-X) Model and the Transforming Episode Accountability Model (TEAM).
Accountable for Health and the Coalition to Transform Advanced Care drafted recommendations that would strengthen the Comprehensive Kidney Care Contracting model and offer a broader roadmap for advancing care for people with serious and chronic illnesses.
This bill creates a permanent ACO option for organizations that want to participate in “full risk.” This program would operate as an additional option alongside the Medicare Shared Savings Program, expanding opportunities to participate in two-sided risk.
Accountable for Health Institute in collaboration West Health brought together leading accountable care experts to discuss how accountable care must evolve to meet the next decade’s challenges. This summary highlights four priority areas to drive system-wide impact.
Kidney-focused accountable care models align incentives around proactive, coordinated, whole-person care. Early results show meaningful gains, including more optimal dialysis starts and increased home dialysis use, demonstrating that better care and lower costs can go hand in hand.
A4H submitted a statement for the record to the U.S. House Ways and Means Health Subcommittee for the hearing on improving kidney health. A4H urges Congress to consider our recommendations to improve kidney health through better prevention, earlier intervention, and the advancement of innovative, accountable care models.
A4H filed comments on the Request for Information related to Comprehensive Regulations to Uncover Suspicious Healthcare. We applaud the Administration for its commitment to program integrity, including skin substitutions payment reform and encourages CMS to better leverage accountable care participants as front line identifiers of potential waste, fraud, and abuse.
Medicare beneficiaries receive significantly more primary and preventive care when their doctors are part of accountable care models, underscoring the sustained gains associated with greater accountability for cost and quality.
Medicare’s accountable care models have demonstrated that, when properly structured and supported, they can improve care experiences, expand access, and lower costs. CMMIs work must continue without undue interference and any legislative strategies should focus on expanding its role in transforming care delivery rather than contracting it.
The Shared Savings Program delivered record results in 2024, generating $2.48 billion in net savings while maintaining exceptional quality. Two-sided risk ACOs drove most of the gains, saving $637 per patient. This analysis highlights why accountability works – and how strong policy design can strengthen Medicare’s long-term sustainability.
From uncovering abuses to securing reform, A4H led a coordinated campaign to expose waste, protect patients, and support CMS’s efforts to bring accountability to the skin substitute market.
A4H Joins Alliance for Connected Care Calling for Long-Term Congressional Fix to Medicare Telehealth
450 signatories urge Congress to work as quickly as possible to reinstate Medicare telehealth access and to work with the Centers for Medicare & Medicaid Services (CMS) to ensure retroactive payment for practitioners that maintained patient access to crucial services during this lapse.
Medicare spending on skin substitutes has grown sevenfold since 2022 – a systemic surge driven by thousands of providers nationwide, not a handful of outliers. This is not a small group of bad actors. The number of high-spend physicians has multiplied across the country.
A4H continues to tell the story about outrageous fraud in the Medicare program with unnecessary skin substations. Read how patients are being harmed and even dying by the mis use of unnecessary skin substitutions.
In a new Health Affairs Forefront piece published on October 7, Accountable for Health CEO Mara McDermott, HarmonyCares’ Will Robinson, and C-TAC’s Kris Smith explain how Medicare’s experience with skin substitutes shows the promise of accountable care and what still needs to happen to fully leverage ACOs as early fraud detectors.
Accountable for Health filed comments supporting proposals to build and deepen accountable care relationships by requiring ACOs in MSSP to move to two-sided models after their first five-year performance proposal. A4H also applauds the Administration for responding to stakeholder requests for new specialty models and supports improvements to the underlying fee-for-service payment structure, including G2211 proposals and new payment proposal for skin substitutes. A4H also urges CMS to work with Congress to ensure that providers in accountable care models remain appropriately incentivized for their efforts and results.
Organizations committed to improving health delivery and health care experiences for people across America, signed a letter to support the proposal to address skin substitute payment in the Medicare Physician Fee Schedule and cap payments at $125 per square centimeter.
This bill creates a permanent ACO option for organizations that want to participate in “full risk.” This program would operate as an additional option alongside the Medicare Shared Savings Program, expanding opportunities to participate in two-sided risk.
Accountable for Health filed comments on the Request for Input recommending the acceleration to adopt accountable care practices that improves health care for all individuals and communities. A4H also urges the Committee to focus on opportunities that are simple and accessible for patients and caregivers.
Accountable for Health members, ilumed, Curana Health, Bloom Healthcare, and HarmonyCares, participated on a panel at the Value-Based Payment Summit on “ACOs and CMS Working Together to Address Low-Value Skin Substitutes”.
A4H encourages stakeholders to weigh in with the Centers for Medicare & Medicaid Services to finalize the proposal in the Medicare Physician Fee Schedule proposed rule.
The Accountable for Health Institute, in conjunction with the West Health Policy Center, identified a need for more standardized core competencies to identify accountable care. This tool and the surrounding content lay out key capabilities of accountable care providers and create a framework for future measurement activities.
A4H files comments in response to CMS’s Request for Information on the Health Technology Ecosystem, urging the agency to ensure technology policies give flexibility for total cost of care organizations to pick technology that works best for them to achieve their clinical and financial goals.
A4H files comments on CMS’s Request for Information in the CY 2026 IPPS Proposed Rule. This is in conjunction with President’s Trump’s executive order “Unleashing Prosperity Through Deregulation, which proposes to significantly reduce the private expenditures required to comply with federal regulation.
A4H files comments in the Fiscal Year (FY) 2026 Hospital Inpatient Prospective Payment System (IPPS) proposed rule on the proposed rules. A4H specifically focused on the Episode Accountability Model (TEAM) and the Request for Information (RFI) on the transition to Fast Healthcare Interoperability Resources (FHIR)-based digital quality measurement.
When Rex, a 70-year-old retired construction worker in Utah, lost his kidney transplant after 24 years, he faced a familiar and daunting reality: a return to in-center dialysis.
See how Housecall Providers accountable care solution helped an aging adult receive care at home providing the patient with the reassurance she needed to live a happier life.
Learn how Housecall Providers help an aging adult through at home care from compassionate clinicians, leading the patient to become a more functional person both mentally and physically.
A4H weights in opposing issues in the recently released reconciliation package that would shift incentives away from value-based care toward a fragmented fee-for-service system.
Congratulations on your new leadership role at the Centers for Medicare & Medicaid Services. We look forward to working with you to advance policies that accelerate the adoption of accountable care to improve health care for all Americans.
See how a partnership with agilon health and Central Ohio Primary Care meet the challenges of patients by providing value-based care dollars to put in place a management care team to provide home health care.
Read how Conversio Health’s value-based program helped a patient regain his mobility and improve his overall health.
See how Vytalize Health build stronger relations with patients with their all-in-one health care solutions.
The CMS Innovation Center (CMMI) recently announced modifications to its model portfolio to align with statutory obligation, including models that are being terminated as planned and models that will not launch or will end early.
Congratulations on your new leadership role at the U.S. Department of Health and Human Services (HHS). We look forward to working with you to Make America Healthy Again by advancing policies that accelerate the adoption of accountable care.
The Accountable for Health Institute and West Health Policy Center convened a roundtable of experts to discuss the accountable care landscape, including barriers to adoption and suggested next steps to continue momentum in building the accountable health care system.
Read how PSW helped a woman in her early 80’s struggling with frequent emergency department visits due to unmanaged anxiety and depression, improve her overall health through their accountable care efforts.
See how a partnership with agilon health and Central Ohio Primary Care meet the challenges of patients by providing value-based care dollars to provide palliative care at home.
A4H and its members contributed to research produced by the American Heart Association (AHA), demonstrating that accountable care organizations had better patient outcomes than traditional fee-for-service. The AHA hosted a congressional webinar to walk through the data and discuss how these findings can inform advocacy efforts to improve care delivery.
The letter calls for Congress to pass an end-of-year health care package that includes an extension of Medicare’s Advanced Alternative Payment Model (AAPM) incentive payments to ensure physicians and other health care providers have the resources needed to support beneficiaries’ continued access to quality care.
Read how SOFHA applied funds generated through the Medicare Shared Savings Program to get this patient the care she needed in our “Accountable Care in Action” case study.
A4H sponsored an episode of the Good Things podcast from Lemonada Media. Wildflower Health CEO Leah Sparks and obstetrician and gynecologist Dr. Fatima Naqvi discussed the promise of value-based care and how it can change the mindset of how healthcare is delivered.
This issue brief outlines the differences in the MSSP, ACO REACH, and Primary Care Flex models and recommends continuity of successful model elements.
Across the country, traditional Medicare beneficiaries are participating in accountable care, which improves their health outcomes and lowers costs. This map shows accountable care participation in traditional Medicare by state (percentage of traditional Medicare beneficiaries in select models.
A4H submitted comments in response to the Centers for Medicare & Medicaid Services (CMS) Medicare Physician Fee Schedule Proposed Rule.
This issue brief summarizes feedback A4H provided on the new mandatory bundles proposal.
Accountable for Health provides input on the 21st Century Cures Initiative RFI, which focuses on future legislation to advance medical research and health care delivery, including provisions impacting biomedical research funding and innovation, mental health care reform, drug development, and health information technology.
A4H Joins Stakeholders Calling for Accelerating Progress in Exchanging Electronic Health Information
The letter calls for accelerating progress in the secure exchange of electronic health information, stating that “unlocking the power of health data holds the promise to improve health outcomes for patients and families, reduce burden for clinicians and other providers, lessen costs for businesses and taxpayers, and target cures to effectively treat illness and save lives.”
Accountable for Health submits comments on CMS’s proposal to mitigate the impacts of significant, anomalous, and highly suspect (SAHS) billing activity on the financial performance of Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs).
14 members of Congress, led by Representatives Darin LaHood (R-IL) and Kim Schrier (D-WA), submitted a letter to Chiquita Brooks-LaSure, Administrator for the Centers for Medicare and Medicaid Services (CMS), expressing strong support for innovative payment models that improve care, enhance patient experiences and reduce costs.
Accountable for Health submitted feedback on the Senate Finance Committee White Paper on Bolstering Chronic Care through Physician Payment: Current Challenges and Policy Options in Medicare Part B.
Accountable for Health submitted comments in response to the proposed Transforming Episode Accountability Model (TEAM).
A4H joins over 600 stakeholders in calling for Congress to reinstate and extend MACRA’s Advanced APM incentive.
Berkeley Research Group analysis highlights accountable care models that have lowered costs. The review shows that almost all accountable care organization (ACO) models and many specialty care models have saved money for the Medicare program.
Accountable for Health joined 10 national organizations calling for the Centers for Medicare & Medicaid Services to hold accountable care organizations harmless for anomalous billing.
MACRA advanced alternative payment model incentives have worked to transform care for Medicare beneficiaries. As Congress revisits this legislation, more can be done to accelerate the transformation.
Berkeley Research Group shares a new analysis of evidence showing that accountable care initiatives expand access to health care services. The report indicates that “continued investment in [value-based care] can further these access gains as payment models are adjusted for long-term financial sustainability.”
This one-page resource document compares fragmented, fee-for-service care for people with kidney disease to whole person care available through accountable care delivery models. Accountable kidney care models are improving people’s health care experiences and outcomes while lowering costs.
A4H has prepared a comparison table showing the different legislative proposals to extend the Medicare Access and CHIP Reauthorization Act advanced alternative payment model (APM) bonus. As a reminder, the 5% bonus expired last year and Congress extended the bonus for a single year at 3.5%. Absent Congressional action, the bonus will expire. A4H is urging lawmakers to pass an extension of the bonus for the 2024 performance/2026 payment year by the end of the year.
Successful value-based care initiatives have proven they can deliver better care for patients at lower costs and can be attractive to individual physicians, clinicians, and delivery systems. As a result, policymakers have set goals to expand provider participation in these initiatives.
CMS released a final rule on CY 2024 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; Continued Implementation of Requirements for Manufacturers of Certain Single-dose Container or Single-use Package Drugs to Provide Refunds with Respect to Discarded Amounts; Medicare Advantage; Medicare and Medicaid Provider and Supplier Enrollment Policies; and Basic Health Program.
A4H joins over 600 stakeholders in calling for Congress to reinstate and extend MACRA’s Advanced APM incentive.
Accountable for Health submitted comments in response to a Request for Information from the Ways and Means Committee regarding innovation and expanding access to accountable care in rural communities.
Accountable for Health submits comments on the Medicare Physician Fee Schedule proposed rule encouraging the agency to adopt policies that accelerate the adoption of accountable care.
Accountable for Health submits comments in response to the Administration’s request for information about episode-based payments.
The fee for service payment model is at the root of some of our health system’s biggest problems. It contributes to waste, rising costs, uncoordinated care, and poor outcomes. As the U.S. population continues to grow and grow older these issues will only get worse. Accountable care models incentivize providers to coordinate care and reduce waste, leading to better outcomes, improved patient experiences, and lower costs.
A glossary of terms to assist with understanding more about accountable care.
Accountable care aims to improve the health care experience for people by encouraging care coordination, creating care teams that communicate with one another, and supporting individuals in their care journey with services that address their medical and non-medical needs.
Accountable for Health submits comments on Senator Cassidy’s legislation to improve care for individuals eligible for Medicare and Medicaid.
The Centers for Medicare & Medicaid Services (CMS) today released a new primary care initiative – the Making Care Primary (MCP) Model – designed to enhance access to high-quality, accountable health care across America. A4H expresses our support.
4 key items that A4H aims to achieve: increase understanding and awareness of accountable care, advance policies that expand access to effective accountable care, improve performance of accountable care contracts and relationships, and support accountable care transformation through standardized and transparent data and technology.
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