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 (ASM) for heart failure. The selected geographic areas covering 47 states and initial participants list have been announced with the final list expected this summer.
  • CMS issued final national coverage determinations for transcatheter tricuspid valve replacement, transcatheter tricuspid edge-to-edge repair, renal denervation and cardiac contractility modulation in 2025 and is currently reconsidering TAVR coverage.
  • 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, began at the start of this year.
  • The agency plans to sunset the traditional Merit-based Incentive Payment System (MIPS) and transition to MIPS Value Pathways by 2029.

Resources

News