CMS proposes broad Medicare payment and accountable-care overhaul

ByDental Info

The proposed changes would make accountable-care organizations easier to join and shift clinicians away from traditional MIPS reporting. Comments are due Sept. 14, 2026.

The Centers for Medicare & Medicaid Services has proposed a broad overhaul of Medicare physician payment and value-based-care programs, including an easier path for clinicians and practices to participate in accountable-care organizations.

The proposal, issued July 14, 2026, would also move clinicians away from traditional reporting under the Merit-based Incentive Payment System, or MIPS, and toward value-based-care pathways. CMS said the changes are intended to modernize physician payment, reduce administrative burden and place greater emphasis on prevention and accountable care.

The changes are proposals, not final policy. The CMS summary does not quantify how many clinicians or organizations could be affected.

What CMS is proposing

Accountable-care organizations, commonly called ACOs, are a central part of the proposal. CMS said it would make ACO participation easier and potentially more rewarding. The agency did not provide in the approved summary a specific number of new organizations or clinicians that would join under the proposed changes.

ACOs are part of Medicare’s value-based-care approach, which links health care delivery and payment to coordinated care and performance goals. In describing the proposal, CMS emphasized prevention and accountable care rather than a system focused primarily on treating patients after they become sick.

The proposal also addresses the Quality Payment Program and MIPS. CMS said it would transition clinicians away from traditional MIPS reporting toward value-based-care pathways. That description does not establish that MIPS would be eliminated. The full effect of the proposed transition would depend on the final rule and any details not included in the agency’s summary.

What the proposal could mean for clinicians

For medical practices and clinicians who participate in Medicare, the proposal could change how performance is reported and how participation in accountable-care arrangements is structured. It could also affect how Medicare encourages preventive and coordinated care.

CMS framed the proposed changes as a way to reduce the administrative work associated with physician payment and quality reporting. The agency’s summary does not establish that the proposal would lower overall Medicare costs, improve health outcomes or produce a specific payment increase for any group.

For patients, the immediate development is a change in the rules process rather than a final change to benefits or physician payments. The approved materials do not specify changes to patient coverage, premiums, services or out-of-pocket costs. Any practical effect on care would depend on the final policy and how clinicians and organizations respond.

Comment deadline and next steps

CMS lists the proposal among its current Original Medicare announcements as part of the calendar year 2027 Physician Fee Schedule proposed rule. The agency says comments on the related proposal are due September 14, 2026.

That deadline gives clinicians, medical practices, health systems and other interested parties an opportunity to respond before CMS decides whether and how to finalize the changes. The proposal remains subject to that review process. Until a final rule is issued, the materials do not establish that Medicare payment formulas, MIPS reporting requirements or ACO participation rules have changed.

The proposal matters because it reaches several parts of Medicare’s physician-payment system at once: how clinicians report performance, how practices participate in accountable-care organizations and how the program encourages prevention and coordinated care. But the size of the affected population, the precise payment consequences and the final treatment of MIPS remain unsettled in the approved CMS materials.

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