ACO REACH & MSSP

CMS’ latest ACO REACH performance data strengthens the case for preserving elements of the model as it sunsets, with 2024 net Medicare savings rising to $988 million and broader reporting pointing to roughly $2.5 billion in cumulative savings as the field prepares for a LEAD transition. At the same time, the Trump administration’s CMS is using the CY 2027 Physician Fee Schedule/MSSP proposed rule to push more physicians toward accountable care—potentially phasing down MIPS, expanding ACO participation pathways, and reshaping incentives for home-based care partnerships—creating both upside for scaled ACOs and uncertainty for REACH participants deciding whether to migrate into MSSP, LEAD, or other risk arrangements. For VBC leaders, the near-term strategic tension is clear: ACO REACH is producing measurable savings just as CMS is signaling a broader redesign of Medicare physician accountability through MSSP and payment-policy changes.