The ACC met with the Center for Medicare and Medicaid Innovation (CMMI) this week to review key elements of the Ambulatory Specialty Model (ASM) for heart failure (HF), including participant selection and attribution for the HF cost measure.

Earlier this month, CMMI released a preliminary list of ASM participants in selected geographic areas. Some ACC members have raised concerns about their inclusion based on their PECOS-enrolled specialty type. The ACC has asked CMMI to reconfirm participant eligibility and validate the list. ACC Advocacy staff will continue to work with affected members to help provide clarity over the criteria for model participation.

In addition, the HF episode-based cost measure, currently used in MIPS, will account for 50% of a participant's ASM score. However, real-world data will not be publicly available until this spring with the release of the 2026 Quality Payment Program Experience Report (utilizing Performance Year 2024 data), making clinician attribution difficult to determine.

The ACC noted this could limit participants' ability to make timely interventions during the performance year and urged CMMI to share any actionable data with participants ahead of ASM implementation on Jan. 1, 2027.

CMMI encourages ASM participants to update their contact information to receive the latest news and updates directly from the agency. ACC members can also visit ACC's ASM webpage to raise additional questions or feedback with ACC Advocacy staff.

Clinical Topics: Heart Failure and Cardiomyopathies, Acute Heart Failure

Keywords: Costs and Cost Analysis, United States, ACC Advocacy, Heart Failure, Medicare