This bill changes how Medicare decides which patients should be assigned to accountable care organizations (ACOs)—groups of doctors and healthcare providers that work together to coordinate patient care and reduce costs. Right now, the system mainly looks at whether patients visit a primary care doctor who works for an ACO. This bill expands that to also count visits to other healthcare professionals working in the ACO, like physician assistants, nurse practitioners, and clinical nurse specialists. In practical terms, if you see any of these types of providers at an ACO instead of just a traditional doctor, you're more likely to be officially assigned to that ACO. This matters because ACOs that are assigned more patients can potentially earn more money when they save Medicare money through better care coordination. The change essentially gives credit to a wider range of healthcare workers for bringing patients into the ACO system, which could encourage more team-based care and make it easier for patients to be part of these coordinated care programs.

ACO Assignment Improvement Act of 2025

Smith, Adrian

ACO Assignment Improvement Act of 2025This bill establishes additional requirements for assigning Medicare fee-for-service beneficiaries to accountable care organizations (ACOs) under the Medicare shared savings program. Under current law, the program enables ACOs to receive payments for savings stemming from care coordination and management.The bill requires the basis for assignment to reflect beneficiaries' utilization of not only primary care services provided by ACO physicians, but also those provided by other ACO practitioners—specifically, physician assistants, nurse practitioners, and clinical nurse specialists.