ACC Urges Changes as Ambulatory Specialty Model Approaches

With the mandatory Ambulatory Specialty Model (ASM) for Heart Failure (HF) slated to begin Jan. 1, 2027, the ACC is prioritizing member awareness and education, while pressing the Centers for Medicare and Medicaid Services (CMS) to address key issues with the model's design and requirements.

ACC's primary concerns regarding the current model include:

• Focusing on the cardiologist as an individual, contrary to the ACC-endorsed standard of the team-based approach to HF treatment.
• Adding administrative and reporting burden.
• Failing to account for specialist and workforce distribution.
• Lacking timely and actionable data for clinicians to improve patient care and outcomes.
• Creating a win-lose-draw structure for all participants.
• Requiring an HF episode cost measure new to MIPS reporting and lacking data transparency for the intended ASM usage.

In response, the College has made the following recommendations to CMS in meetings with agency staff and through formal written comments:

• Limit ASM downside and upside risk at +/–2% using a phased-in approach tied to the model's stability and participant readiness.
• Require at least one dedicated educational and testing year before financial accountability begins.
• Provide participants with actionable, near-real-time cost and quality data to support timely clinical decision-making.
• Replace individual-clinician attribution with a team-based methodology that reflects the multidisciplinary nature of HF care.
• Establish a built-in goal score based on guideline-directed clinical care that protects participants achieving meaningful improvement from financial penalties.
• Incorporate risk-adjustment for clinical complexity, comorbidities and social determinants of health.

Looking for more information on how to prepare for the ASM for HF? Visit ACC.org/ASMForHF to access resources developed by ACC's Payer and Policy Team.

Register Today For ACC Legislative Conference 2026

It's time to register for ACC Legislative Conference 2026, happening Oct. 4-6 in Washington, DC! Grab a front-row seat to the decisions shaping the future of cardiovascular care, connect with ACC leaders and fellow clinicians dedicated to advocacy, and make your voice heard on Capitol Hill.

Last year, more than 400 cardiovascular clinicians, including 100 young professionals and 50 cardiovascular team members, joined ACC Advocacy to advocate for their patients on the Hill. Attendees participated in close to 300 meetings with congressional offices, increasing co-sponsorships for several ACC priority bills such as the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) For Health Act, the Resident Education Deferred Interest (REDI) Act and the Increasing Seniors' Timely Access to Care Act.

Throughout 2026, ACC Advocacy staff have been working to educate lawmakers, strengthen relationships with health policy champions and continue to advance the College's priorities. A strong showing from the cardiology community is essential so that Congress understands the real-world impact policy decisions have on patient care.

According to Samuel O. Jones IV, MD, MPH, FACC, "Now more than any other time we've got to be engaged. I really appreciate the ACC letting me, and 400 of my closest colleagues from around the cardiovascular care team, come up and advocate for those issues that are important to us and our patients."

Don't miss ACC's most impactful advocacy event of the year! Learn more and register at ACC.org/LegislativeConference.

Clinical Topics: Cardiovascular Care Team, Heart Failure and Cardiomyopathies, Acute Heart Failure

Keywords: Cardiology Magazine, ACC Publications, CM-Jul-Aug-2026, Centers for Medicare and Medicaid Services, U.S., Health Policy, Legislative Conference, Heart Failure, ACC Advocacy, Ambulatory Care