Support Clinicians in Providing Equitable Value-Based Care

The ACC advocates for value-based payment models that improve cardiovascular care by encouraging collaboration among cardiovascular clinicians and primary care. These models should reward efficient care delivery and focus on the needs of patients. By establishing timely and actionable performance data and evidence-based quality standards across all payers, value-based care solutions can help promote health equity and support various practice settings, including cardiovascular subspecialties.

ACC in Action

  • The College routinely provides the Centers for Medicare and Medicaid Services (CMS) feedback on value-based care proposals made through requests for information and rulemaking.
  • The ACC engages with private payers to mitigate coverage issues impacting the delivery of cardiovascular care.

Policy Progress

  • In the 2026 Medicare Physician Fee Schedule final rule, CMS finalized the Ambulatory Specialty Model for heart failure, a five-year mandatory model designed to test whether episode-based accountability for chronic conditions can improve outcomes and reduce total cost of care.
  • CMS has issued a final national coverage determination (NCD) for tricuspid transcatheter edge-to-edge repair and draft NCDs for renal denervation and cardiac contractility modulation.
  • The Center for Medicare and Medicaid Innovation revised its strategic direction to emphasize three new pillars: promote evidence-based prevention, empower people to achieve their health goals, and drive choice and competition. In new pilot models, the agency aims to include prevention-based measures and site-neutral payment policy.
  • The Transforming Episode Accountability Model (TEAM) program, a five-year mandatory, episode-based alternative payment demonstration project for CABG and other procedures in select acute care hospitals, will begin on Jan. 1, 2026.
  • The agency plans to sunset the traditional Merit-based Incentive Payment System (MIPS) and transition to MIPS Value Pathways by 2029.

Resources

News