ACO Models & MSSP

ACO/MSSP stakeholders are using the CY 2027 Physician Fee Schedule and Medicare Shared Savings Program comment window to press CMS under the Trump administration for a more participation-friendly accountable care framework—stronger primary care investment, reduced reporting and administrative burden, better interoperability, and payment updates that preserve downside-risk accountability without discouraging physician-led ACOs. Premier and the Health Care Transformation Task Force both framed the core tension as balancing broader ACO participation with credible quality and cost discipline in MSSP and related physician payment policy (Premier comments; HCTTF comments). Meanwhile, market activity around Aledade, agilon, and proposed ACO LEAD Medicare-Medicaid risk-contract design signals continued private-sector positioning for advanced primary care and multi-payer risk, even as stakeholders push CMS for simpler quality measurement and more predictable model economics.