This bill changes how Medicare decides which patients belong to Accountable Care Organizations (ACOs), which are groups of doctors and healthcare providers that work together to coordinate patient care and reduce costs. Currently, Medicare assigns patients to ACOs based on which doctor they see most often for primary care. This bill expands that rule starting in 2026 to also count visits to nurse practitioners, physician assistants, and clinical nurse specialists as primary care services for assignment purposes. In practical terms, if you see one of these healthcare professionals for your main medical care instead of a traditional doctor, that visit will now count toward determining which ACO you're assigned to. This matters because it gives more flexibility in how patients are matched with ACOs and recognizes that these other healthcare professionals often provide the same primary care services as doctors do. The change could help ACOs better coordinate care for their patients and might affect which healthcare network you're considered part of based on who you regularly see for checkups and basic medical care.

ACO Assignment Improvement Act of 2025

Barrasso, John

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.