House Passes Bill to Ease Medicare ACO Digital Quality Reporting Burden

The Health Care Efficiency Through Flexibility Act (HR 5347), sponsored by Rep Vern Buchanan (R, Florida), unanimously passed the House of Representatives on Monday.¹

The bill aims to improve digital reporting and provide greater flexibility for accountable care organizations (ACOs) participating in the Medicare Shared Savings Program. Under the program, participating ACOs are required to report quality measures to demonstrate performance and savings digitally. However, a lack of information technology (IT) infrastructure or software creates barriers for smaller, rural, and independent physicians’ practices within an ACO. The bill would delay certain requirements related to quality-measure reports from Shared Savings Program ACOs and establish a pilot program to test alternative digital reporting methods for ACOs.

“This bill takes a practical step by preserving flexibility in how ACOs report quality measures while the health care system continues its transition toward digital quality measurement,” Mara McDermott, CEO of Accountable for Health, wrote in a statement to The American Journal of Managed Care^®.

CMS began implementing digital reporting requirements at the beginning of 2025. But with this bill, ACOs would be able to continue quality-measure reporting using prior methods through 2029, allowing smaller practices within ACOs the flexibility to report quality measures “the way that suits them best,” House Ways and Means Committee Chairman Jason Smith (R, Missouri) said in a written statement.¹

The mandated pilot program included in the bill states that the CMS must establish the program from 2028 to 2032. However, ACOs that choose to participate in the pilot program are exempt from using other methods. The pilot program aims to streamline the transition to digital quality-measure reporting for smaller, rural, and independent practices, which are expected to benefit from continued participation in the program.²

“By maintaining multiple quality reporting options through 2029 and supporting a thoughtful path toward more modern reporting systems, the legislation recognizes both the promise of digital innovation and the realities of today’s health IT infrastructure,” McDermott wrote.

Furthermore, in 2024, Shared Savings Program ACOs earned $4.1 billion in shared savings payments while generating net savings for Medicare of $2.5 billion.³

As of 2026, ACOs deliver care to an estimated 14.3 million Medicare beneficiaries, a 4.4% increase from 2025. More providers and practices are choosing to participate in the Shared Saving Program, further highlighting the benefits for both patients and participating practices. CMS approved 134 applications for the Shared Savings Program, 72 of which were new ACOs and 62 renewing or returning ACOs. There are a total of 511 ACOs enrolled in this savings program as of February 2026, a 7.4% increase from 2025.³

By making quality-measure reporting more flexible, the act has the potential to appeal to smaller, more rural, and independent practices that are looking to deliver high-quality care while maintaining or increasing savings for themselves and patients.

“This approach would align reporting mandates with accountable care organizations’ efforts to improve the quality of care and reduce administrative costs, allowing physicians and other clinicians to put more resources back into patient care,” Emily Brower, president and CEO of the National Association of ACOs, said in a written statement.¹

For managed care professionals, the ultimate aim is to reduce health care spending for providers and patients alike. If enacted, the bipartisan Health Care Efficiency Through Flexibility Act would reduce the burden for smaller and rural practices participating in ACOs while supporting continued access to value-based care.

References

1. Buchanan bill to support health care providers passes House in unanimous vote. News release. Congressman Vern Buchanan. June 29, 2026. Accessed June 30, 2026. https://buchanan.house.gov/2026/06/29/buchanan-bill-to-support-health-care-providers-passes-house-in-unanimous-vote/

2. HR 5347 - 119th Congress (2025-2026): Health Care Efficiency Through Flexibility Act. Congress.gov. June 29, 2026. Accessed June 30, 2026. https://www.congress.gov/bill/119th-congress/house-bill/5347

3. 2026 Medicare accountable care organization initiatives participation highlights. CMS. February 4, 2026. Accessed June 30, 2026. https://www.cms.gov/newsroom/fact-sheets/2026-medicare-accountable-care-organization-initiatives-participation-highlights