CMS is proposing transformational reforms to Medicare’s physician payment and value-based care programs that would expand accountable care, modernize physician payment, reduce administrative burden, and help shift the healthcare system’s focus from treating illness to preventing it.
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Highlights from recently released Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (Innovation Center) evaluation reports and publications.
CMS continues to bring accountable care to more people with Medicare in 2026, expanding the benefits of high-quality, whole-person health care to achieve better health outcomes for millions of older Americans.
By Amy Ardisana – CMS has released the 2026 Physician Fee Schedule Proposed Rule, proposing several changes to the QPP and its reporting frameworks. Unlike previous years marked by extensive regulatory overhauls, CMS has proposed a limited number of policies, emphasizing its commitment to program stability while continuing the strategic transformation of healthcare quality measurement.
CMS has issued its, Calendar Year 2026 Medicare Physician Fee Schedule Final Rule, which includes policies for the Quality Payment Program for the 2026 performance year and beyond. This rule will be published on November 5, 2025, in the Federal Register.
CMS has made substantial progress on its goal for all people with Traditional Medicare to be in a care relationship with accountability for quality and total cost of care by 2030. As of January 2025, 53.4% of people with Traditional (fee-for-service) Medicare are in an accountable care relationship with a provider.
By Matt Fisher – Value based care has become an evergreen topic in healthcare circles with the accompanying message that value based care will transform healthcare. Is that transformation happening? Is the value based care discussion stagnating or getting stuck on certain concepts?
By Misty Graham – Key stakeholders in the healthcare industry, including health plans, clinical data registries, and accountable care organizations, must collaborate to improve health outcomes, enhance patient experiences, manage chronic diseases, and provide better access to care while keeping costs low.
By James Pelletier – CMS has introduced significant proposals that impact the Medicare Shared Savings Program and the transition from MIPS to MVPs for 2025. Understanding these changes is essential for improving patient care and optimizing financial outcomes.