On July 10, 2024, the Centers for Medicare & Medicaid Services (CMS) released the proposed rule for the 2025 Medicare Physician Fee Schedule (PFS). The proposed rule includes several key changes affecting Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs), as CMS continues its shift towards digital quality measures (dQMs). With the CMS Web Interface concluding after the 2024 performance year, the proposed rule focuses on the future of quality reporting by aligning with the Universal Foundation of quality measures and extending electronic Clinical Quality Measure (eCQM) reporting incentives. This blog summarizes the proposed changes and examines their implications for ACOs in 2025 and beyond.