On February 4, the Facilities for Medicare & Medicaid Companies (CMS) launched a truth sheet in regards to the 2026 Medicare Accountable Care Group (ACO) participation. As of January 2026, an estimated 14.3 million Medicare beneficiaries will obtain care coordinated by ACOs, up from 13.7 million in 2025, marking a 4.4 p.c improve, CMS reported. This contains sufferers whose healthcare suppliers take part in Medicare Shared Financial savings Program ACOs, and entities concerned in CMS Innovation Heart accountable care fashions, in addition to different CMS Innovation Heart fashions centered on whole value of care, superior main care, and specialty care.
ACOs obtain financial savings as a result of healthcare suppliers are held accountable for lowering prices and enhancing high quality of care, delivering a win for each sufferers and the Medicare Belief Funds, CMS defined. “In Efficiency Yr 2024, essentially the most not too long ago reconciled efficiency yr, Shared Financial savings Program ACOs earned shared financial savings totaling $4.1 billion and saved Medicare $2.5 billion.”
CMS said that the present administration continues to develop ACO participation by means of adjustments to the Shared Financial savings Program and CMS Innovation Heart fashions:
- In 2026, 82.8 p.c of Shared Financial savings Program ACOs are in Degree E of the BASIC monitor or the ENHANCED monitor, each of which meet the standards to be an Superior Various Cost Mannequin (Superior APM) beneath the High quality Cost Program.
- CMS finalized adjustments within the CY 2026 Doctor Price Schedule Closing Rule which are meant to extend the variety of Shared Financial savings Program ACOs taking part in two-sided threat, during which organizations are accountable for losses in addition to financial savings.
- The ACO REACH Mannequin up to date its monetary methodology in 2025 to make sure future value financial savings.
- The not too long ago introduced Lengthy-term Enhanced ACO Design (LEAD) Mannequin will launch in 2027 on the conclusion of ACO REACH. LEAD builds upon earlier accountable care work whereas interesting to a broader mixture of well being care suppliers, together with these with specialised affected person populations and people new to ACOs, resembling smaller, unbiased, or rural-based practices.
CMS Accountable Care Group initiatives — participation highlights:
- For the 2026 efficiency yr, CMS authorised 134 purposes for the Shared Financial savings Program, together with 72 new ACOs and 62 renewing or reentering ACOs. This brings the overall variety of ACOs taking part within the Shared Financial savings Program for Efficiency Yr 2026 to 511, up from 476 ACOs taking part in 2025. These Shared Financial savings Program ACOs, with greater than 700,000 well being care suppliers and organizations, will serve 12.6 million folks with Conventional Medicare, a 12.3 p.c improve.
- The ACO REACH Mannequin contains 74 ACOs, 125,909 healthcare suppliers and organizations, and roughly 1.7 million folks with Conventional Medicare. In 2026, this mannequin options 614 Federally Certified Well being Facilities, Rural Well being Clinics, and Crucial Entry Hospitals taking part.
- The Kidney Care Selections (KCC) Mannequin contains 74 Kidney Contracting Entities (KCEs), that are accountable for the standard of care and the care of their aligned sufferers beneath Conventional Medicare.
- The ACO PC Flex Mannequin entails 23 ACOs serving 359,720 folks with Conventional Medicare and exams a brand new main care fee mannequin throughout the Shared Financial savings Program.
Medicare beneficiaries whose physicians take part in accountable care organizations (ACOs), significantly these taking over monetary threat for value and high quality, obtain considerably extra main and preventive care than beneficiaries exterior these fashions, based on new information launched by Accountable for Well being, as reported by Pearl Steinzor on February 4 for AJMC. “By shifting from conventional fee-for-service fashions—which reimburse per go to or process—to frameworks that reward high quality and outcomes, ACOs can empower clinicians to emphasise prevention, continuity of care, and proactive administration of continual situations.”
