On February 4, the Facilities for Medicare & Medicaid Providers (CMS) launched a truth sheet in regards to the 2026 Medicare Accountable Care Group (ACO) participation. As of January 2026, an estimated 14.3 million Medicare beneficiaries will obtain care coordinated by ACOs, up from 13.7 million in 2025, marking a 4.4 p.c improve, CMS reported. This contains sufferers whose healthcare suppliers take part in Medicare Shared Financial savings Program ACOs, and entities concerned in CMS Innovation Middle accountable care fashions, in addition to different CMS Innovation Middle fashions targeted on whole price of care, superior main care, and specialty care.
ACOs obtain financial savings as a result of healthcare suppliers are held accountable for lowering prices and bettering high quality of care, delivering a win for each sufferers and the Medicare Belief Funds, CMS defined. “In Efficiency Yr 2024, probably the most lately reconciled efficiency yr, Shared Financial savings Program ACOs earned shared financial savings totaling $4.1 billion and saved Medicare $2.5 billion.”
CMS acknowledged that the present administration continues to develop ACO participation by way of modifications to the Shared Financial savings Program and CMS Innovation Middle fashions:
- In 2026, 82.8 p.c of Shared Financial savings Program ACOs are in Stage E of the BASIC monitor or the ENHANCED monitor, each of which meet the standards to be an Superior Different Fee Mannequin (Superior APM) underneath the High quality Fee Program.
- CMS finalized modifications within the CY 2026 Doctor Charge Schedule Ultimate Rule which might be meant to extend the variety of Shared Financial savings Program ACOs collaborating in two-sided threatthrough which organizations are accountable for losses in addition to financial savings.
- The ACO REACH Mannequin up to date its monetary methodology in 2025 to make sure future price financial savings.
- The lately introduced Lengthy-term Enhanced ACO Design (LEAD) Mannequin will launch in 2027 on the conclusion of ACO REACH. LEAD builds upon earlier accountable care work whereas interesting to a broader mixture of well being care suppliers, together with these with specialised affected person populations and people new to ACOs, equivalent to smaller, unbiased, or rural-based practices.
CMS Accountable Care Group initiatives — participation highlights:
- For the 2026 efficiency yr, CMS accepted 134 purposes for the Shared Financial savings Program, together with 72 new ACOs and 62 renewing or reentering ACOs. This brings the whole variety of ACOs collaborating within the Shared Financial savings Program for Efficiency Yr 2026 to 511, up from 476 ACOs collaborating in 2025. These Shared Financial savings Program ACOs, with greater than 700,000 well being care suppliers and organizations, will serve 12.6 million individuals with Conventional Medicare, a 12.3 p.c improve.
- The ACO REACH Mannequin contains 74 ACOs, 125,909 healthcare suppliers and organizations, and roughly 1.7 million individuals with Conventional Medicare. In 2026, this mannequin options 614 Federally Certified Well being Facilities, Rural Well being Clinics, and Essential Entry Hospitals collaborating.
- The Kidney Care Selections (KCC) Mannequin contains 74 Kidney Contracting Entities (KCEs), that are chargeable for the standard of care and the care of their aligned sufferers underneath Conventional Medicare.
- The ACO PC Flex Mannequin entails 23 ACOs serving 359,720 individuals with Conventional Medicare and exams a brand new main care cost mannequin inside the Shared Financial savings Program.
Medicare beneficiaries whose physicians take part in accountable care organizations (ACOs), significantly these taking up monetary threat for price and high quality, obtain considerably extra main and preventive care than beneficiaries outdoors these fashions, in response to new information launched by Accountable for Well beingas reported by Pearl Steinzor on February 4 for AJMC. “By shifting from conventional fee-for-service fashions—which reimburse per go to or process—to frameworks that reward high quality and outcomes, ACOs can empower clinicians to emphasise prevention, continuity of care, and proactive administration of power situations.”
