Evolving healthcare regulations and reimbursement policies deeply impact physicians’ day-to-day work delivering quality care to their patients. This year, the Centers for Medicare & Medicaid Services (CMS) introduced numerous proposed changes related to expanding accountable care participation, modernizing physician reimbursement, and optimizing reporting processes. These updates reflect a push for proactive healthcare practices that prevent rather than merely treat chronic illness.

Accountable Care Expansion

One of the primary goals of CMS’ recent proposals is increasing Accountable Care Organization (ACO) participation to improve patient care and lower healthcare costs. CMS reports in its recent July 2026 press release that patients receiving care from ACOs are more likely to receive preventative screenings and better able to manage chronic disease, making participation beneficial for patients and providers alike.

In 2027, CMS proposes significant improvements to the Medicare Shared Savings Program to empower more providers to participate in ACOs. These improvements include additional opportunities for shared savings, new financial incentives for first-time joiners, predictable spending targets, and more streamlined technology requirements. Jointly, these proposed changes are designed to make ACO participation more accessible and financially feasible.

Physician Reimbursement Updates

CMS acknowledges that many preexisting payment and billing processes are outdated and don’t always accurately account for the time and resources required to provide healthcare services. As a result, CMS has proposed recalibrated payment rates to better represent the complexity of care delivery, including helping to align claims with actual services provided.

Some of these proposed changes include lower reimbursements when accounting for multiple services being delivered during the same patient encounter and higher evaluation and management (E/M) reimbursements for ACO physicians engaging in care coordination. These collectively recognize the added complexity of longitudinal care while also acknowledging overlapping time and resources.

Advancing Quality Reporting

One of the other areas of CMS’ proposed changes is how physicians report and measure quality of care through Medicare. The Merit-based Incentive Payment System (MIPS) has traditionally evaluated participating clinicians since 2017 based on a number of factors such as cost-effectiveness and demonstrated improvement plans. New proposed advancements would shift away from MIPS to MIPS Value Pathways (MVPs), which streamline reporting requirements around physicians’ specialties and their unique patient populations.

Beginning in 2027, CMS proposes introducing MIPS Core Measures, which would require clinicians to report at least one quality measure considered fundamental to their specific patient population with the goal of generating more meaningful and relevant data for physicians, patients, and stakeholders. By making quality measures more specific to the care physicians actually provide, these proposed changes aim to continue Medicare’s transition toward value-based reimbursement rather than traditional fee-for-service models.

Delivering quality healthcare begins with putting providers and patients first. The Greater Michigan Physician Network is passionate about keeping its partner physicians updated on relevant regulatory updates and helping them to navigate a consistently evolving healthcare system.