MDinteractive joined Accountable Care Organization (ACO) leaders and industry partners at the 2026 Fall NAACOS Conference, where new payment models, quality reporting, and digital health technology were prominent themes. For ACOs, these developments raise a practical question: how can they meet current demands while building the capabilities they will need next?
Our breakfast session, “Navigating ACO Quality Reporting: How to Choose the Right Path and Invest for the Digital Future,” focused on that question. Drawing on our work with ACOs across diverse practice and EHR environments, we shared lessons on selecting a reporting path and building the data foundation for digital quality measurement.
New models bring data and technology decisions into focus
As new CMS models create opportunities, ACOs must consider how their data infrastructure and partnerships can support evolving care delivery and performance goals.
CMS’s Long-term Enhanced ACO Design (LEAD) Model, scheduled to begin in 2027, aims to broaden ACO participation and better support care for patients with complex needs. The Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model tests payments tied to outcomes for technology-supported chronic care.
For ACOs evaluating technology and potential partners, key questions include: Can the solution connect with existing systems? Will the data be accessible and useful? How will it fit into the work of participating practices?
Choosing a reporting path requires looking beyond submission
In our presentation, we explored how Medicare Shared Savings Program (MSSP) ACOs can choose a reporting path that supports current performance goals and prepares them for future digital reporting, using real-world examples.
We discussed the existing eCQM, MIPS CQM, and Medicare CQM pathways alongside proposed changes. In its 2027 proposed rule, CMS proposed extending MIPS CQMs and their reporting incentive beyond 2026 and adding Medicare eCQMs beginning in 2027. The proposed Medicare eCQM option would use the ACO’s assigned beneficiary population and flat benchmarks, without the eCQM/MIPS CQM reporting incentive.
With more options to consider, ACOs need to understand how each pathway could affect their performance, shared savings, and operational burden. Our discussion centered on four questions:
- Which pathway offers the strongest opportunity to meet the quality performance standard?
- Can participating practices and their EHRs provide complete, reliable data?
- How much work will it take to collect, combine, and validate that data?
- Can the investment support other value-based contracts and the move to digital quality measures?
MDinteractive helps ACOs compare expected quality performance and the potential impact on shared savings across reporting options, taking into account their practice participation, EHR capabilities, data quality, and longer-term goals. This assessment helps each ACO make an informed decision about the reporting path best suited to its organization.
FHIR supports current reporting and future readiness
Our presentation highlighted how ACOs are using Fast Healthcare Interoperability Resources (FHIR) today to address gaps in EHR exports, access data when QRDA I files are unavailable, and capture additional clinical information needed to assess quality performance.
These experiences reinforce the value of starting early. Testing FHIR connections gives ACOs time to validate the data, resolve issues with practices and EHR vendors, and build experience that can support future digital quality reporting.
Building data capabilities that extend across quality programs
We also discussed how investments in quality data reporting can support other value-based contracts and broader quality improvement efforts. A common data foundation can help ACOs expand to additional measures and patient populations as their needs evolve.
Accessible patient-level data is central to this approach. The ability to investigate results, identify missing information, and share findings with practices makes the data more useful throughout the year. Investments in data infrastructure should support both current reporting and future digital quality measures (dQMs).
Preparing for digital reporting now
A practical starting point is to review participating practices’ EHR capabilities, identify recurring data gaps, and select practices for initial FHIR testing. Comparing retrieved data with existing reports can help ACOs uncover issues and establish a reliable process before expanding connections.
The reporting path an ACO chooses today should fit its current needs while allowing it to build toward future requirements. MDinteractive helps ACOs connect those decisions with a clear plan for data collection, validation, and digital readiness.
ACOs interested in discussing reporting options or where to begin with FHIR can reach us at support@mdinteractive.com or schedule time with our team.