ACO REACH & MSSP

ACO strategy discussions over the past week centered less on new CMS rulemaking and more on operational readiness for the next phase of Medicare accountable care, with stakeholders preparing for 2027-era model design, MSSP participation decisions, and broader specialist/post-acute integration under the Trump administration’s CMS. Duke-Margolis is convening around evidence and policy options for accountable care in 2027, while AMGA is pushing provider groups toward concrete ACO readiness steps—governance, data infrastructure, physician alignment, and change management—signaling that ACO growth is increasingly constrained by execution capacity rather than interest alone. Adjacent VBC activity also points to broader model convergence: TEAM is being framed as a post-acute value opportunity for home health providers, and condition-based specialist models such as BCBSM/TRIARQ’s MSK approach are testing how ACOs and payers can bring specialists into longitudinal cost-and-quality accountability rather than leaving them outside population-based incentives.