Quality Metrics

CMS moved forward on specialty and chronic-care value-based payment, releasing the final 2027 participant list for the Ambulatory Specialty Model while Medicare’s ACCESS chronic disease technology pilot is expanding—signals that the Trump administration’s CMS under Dr. Mehmet Oz and CMMI Director Abe Sutton is tying more reimbursement to longitudinal outcomes, specialty performance, and tech-enabled population management. Provider groups are simultaneously pressing CMS to narrow downside risk and protect access: ASCO is warning that 2027 outpatient payment updates must safeguard cancer care, while the Bipartisan Policy Center and surgical/hospital stakeholders are using PFS and payment-rule comments to push for quality measures and incentives that reward outcomes without destabilizing specialty practices. For ACOs, payers, and health systems, the near-term implication is a faster pivot toward specialty-aligned quality metrics, chronic disease management infrastructure, and evidence that “results, not volume” models can work across high-cost service lines like cardiology, oncology, and surgery (ACC on 2027 Ambulatory Specialty Model participants; Medical Economics on Medicare ACCESS model).