The proposed changes to the Medicare Shared Savings Program for the 2027 Medicare Physician Fee Schedule are generating positive reactions from stakeholders. The Centers for Medicare & Medicaid Services announced modifications intended to make ACO participation easier and more financially rewarding. Officials claim the updates will help clinicians transition away from traditional reporting toward value-based care pathways and update payment policies to reflect modern clinical practice. These adjustments aim to streamline the administrative burden while simultaneously incentivizing high-quality outcomes for patients.
Stakeholders React to New ACO Guidelines
Accountable for Health, an advocacy group representing ACOs, said the proposed rule takes meaningful steps in the right direction. The organization appreciates the focus on prospective primary care payment, support for shared medical appointments, and better integration of behavioral health. They also welcome the new tools to reduce cost barriers for beneficiaries. The group noted that a more prevention-oriented future requires payment policies that give teams the flexibility and resources needed to deliver whole-person care at scale. This approach prioritizes the patient experience over rigid metrics.
Related: Innovation Principles Guide Hartford HealthCare’s Quality Access
America’s Physician Groups, or APG, highlighted specific financial wins. The shared savings rate for Level E of the MSSP BASIC track is proposed to increase from 50 percent to 60 percent. This is the fifth consecutive year of growth, officials noted. APG also noted a change allowing ACOs to add 75 percent of previously achieved savings back into their benchmarks when renewing contracts. This addresses the “ratchet effect” that tends to lower benchmarks and make it harder for ACOs to succeed as they become more efficient. Stakeholders also applauded the proposal to reduce or eliminate beneficiaries’ Part B cost sharing to attract them to an ACO. The focus shifts toward attracting patients to the new model.
Changes to MIPS and New Value Pathways
A significant portion of the proposal addresses the Merit-based Incentive Payment System. CMS is proposing to sunset traditional MIPS reporting in 2029. The goal is to transition clinicians toward Specialty-focused MIPS Value Pathways, or MVPs. CMS stated that when MIPS launched in 2017, the goal was to move Medicare away from a fragmented fee-for-service system toward one that rewards quality and value. The proposed rule makes MVPs the primary reporting option. Beginning in the 2029 performance period, traditional MIPS will sunset. Eligible clinicians would have until the end of 2028 to transition to an MVP unless they participate in a MIPS APM and report the APM Performance Pathway.
Related: AI listening aids rural New Mexico hospital care
CMS is proposing three new MVPs focused on diabetes, hypertension, and hospital-based care. If finalized, the inventory would provide a relevant reporting option for roughly 98 percent of specialties. CMS also extended the ability for ACOs to report quality outcomes via MIPS Clinical Quality Measures. This offers an alternative to electronic clinical quality measures, which some participants and EHR systems are not yet ready to support. The agency is seeking feedback on transitioning reporting processes to FHIR-based digital approaches. America’s Physician Groups, however, described the overall physician fee rule as a “double-
