AHA Coalition Urges CMMI to Delay Mandatory Specialty Payment Model

A coalition of healthcare organizations, including the AHA, sent a letter Oct. 27 to the Center for Medicare and Medicaid Innovation (CMMI) recommending changes to its Ambulatory Specialty Model. The mandatory payment model, set to begin Jan. 1, 2027, targets specialty care for Medicare beneficiaries with heart failure or low back pain. The coalition asked CMMI to delay the launch or, if not delayed, hold participants harmless from downside risk in the first year, and requested ongoing data, operational guidance, technical support and a consolidated help desk. They also urged CMMI to share performance thresholds before the start date and allow practice-level quality reporting to reduce burden.