Scaling ACO Impact: Key NAACOS Takeaways & The Garage's 2026 Vision

NAACOS continues to be a powerful space for reconnecting with partners, meeting new leaders, and exchanging bold ideas about the future of value-based care. This year's NAACOS Fall Conference Conversations underscored both the opportunities and challenges facing ACOs as they prepare for a more digitally connected, data-intelligent, and accountable future.

At this year's NAACOS conference, The Garage shared an early look at our 2026 ACO Operational Framework - a connected, intelligent ecosystem designed to help ACOs:

• Navigate rising regulatory complexity (CMS quality reporting, equity stratification, downside risk)
• Streamline workflows and reduce administrative burden through AI-driven automation
• Strengthen interoperability across EHRs, payer systems, and SDOH data
• Embed governance, change management, and audit-readiness by design

These pillars align directly with what ACO leaders emphasized throughout the conference: operational efficiency, data accuracy, and scalable risk readiness.

Our Key Takeaways from NAACOS Fall 2025 Conference

CMS's Notable Absence amid the Government Shutdown

The absence of CMS was a major takeaway, signaling a lack of visible support at a time when the industry is hungry for clarity, partnership, and leadership. This left a gap where much-needed conversations could've happened via direct engagement. While the industry is navigating complex regulatory shifts, preparing for new models, and striving to scale to value-based care, organization leaders needed real-time dialogue. In the absence of CMS, the ACO community itself stepped up, sharing strategies and frameworks that reflected an industry not waiting for Washington to lead.

Behavioral Health Takes Center Stage: From Innovation to Imperative

Behavioral health was a dominant theme throughout NAACOS Fall 2025, signaling a pivotal shift: integrating behavioral health is no longer a novel innovation but an expected foundation for value-based care. CMS's Innovation in Behavioral Health (IBH) Model, launched earlier this year, continues to guide efforts to fully integrate behavioral and physical health for Medicare and Medicaid populations with significant mental health and substance use challenges.

Alongside IBH, the AHEAD Model is expanding in 2026, emphasizing population health accountability with a strong focus on prevention, chronic disease management, and equity all deeply interconnected with behavioral health.

Importantly, conversations consistently underscored that interoperability remains a major hurdle. Many ACOs are still wrestling with the complexities of connecting behavioral health data to traditional clinical and population health platforms, hampered by privacy rules and fragmented systems.

The energy around behavioral health at NAACOS reflects an industry-wide recognition that effective mental health integration is key to improving outcomes, advancing equity, and managing costs sustainably. The conversation moved from "if" we should integrate to "how" we operationalize and scale integration across diverse care settings.

Bridge is actively addressing these challenges. Our platform integrates behavioral health data streams with clinical and SDOH inputs to create a seamless, interoperable ecosystem. This empowers ACOs to identify behavioral health needs in real time, coordinate care across providers, and measure equity-driven outcomes effectively.

TEAM Model: Expanding Accountability for Surgical Episodes

TEAM was a major topic at NAACOS, signaling CMS's next step in connecting specialty care to value. Launching in January 2026, the Transforming Episode Accountability Model (TEAM) is a mandatory, episode-based model that holds hospitals accountable for cost and quality across five high-volume surgical procedures - from joint replacements to spinal fusions and CABG.

Replacing BPCI Advanced, TEAM links specialty care spending and outcomes under a quality-adjusted target price. For ACOs, it highlights the growing need for cross-setting collaboration, aligning hospitals, surgeons, and post-acute partners through shared data and performance goals.

The message was clear: TEAM is where episode-based care meets total cost of care accountability. At The Garage, we're already helping partners like Adventist Health build the data, governance, and interoperability needed to succeed in this new era of coordinated accountability.

Urgent Focus on Risk Capture and Data Accuracy

A sense of urgency permeated discussions around risk capture and data accuracy. With shared savings programs facing financial constraints, organizations are prioritizing precise risk adjustment and robust data validation to stabilize performance and maximize impact. This focus is critical for sustaining success in an increasingly challenging environment.

Financial sustainability is top of mind for our partners. The Garage's Bridge platform delivers robust analytics and predictive insights, enabling organizations to capture risk accurately and validate data in real time. We help ACOs maximize shared savings and navigate thin margins by providing tools that support confident, data-driven decision-making.

Interoperable SDOH and Quality Data for Equitable Improvement

A key takeaway at NAACOS was the growing urgency to make Social Determinants of Health (SDOH) and quality data truly interoperable. Leaders emphasized that while nearly every ACO collects SDOH data, most are still in the early stages of SDOH maturity-struggling to integrate community-based insights into clinical workflows and population health strategies.

The next frontier of interoperability is clear: connecting community-based organizations, payers, and ACOs into a unified data ecosystem for real-world equity measurement. This level of collaboration is essential for turning SDOH insights into actionable, measurable improvements in care delivery and outcomes.

At The Garage, we're committed to advancing health equity through data interoperability. Our solutions integrate SDOH and quality data across EHRs and payer systems, empowering organizations to identify disparities, target interventions, and measure progress toward equitable outcomes. With this foundation, we help ensure improvement efforts reach every patient-regardless of background, community, or circumstance.

Turning Strategy into Action

During the conference, Organizations discussed how value-based care requires a clear strategy and actionable tools that produce measurable outcomes. Practical examples emphasized how designing better contracts, capturing disease burden, optimizing networks, and supporting physician performance directly impact quality and financial results.

The Garage is already doing this. Our ACO Operational Framework converts these high-level goals into day-to-day operational workflows, enabling measurable improvements in outcomes, cost management, and provider engagement.

Driving Population Health at Scale

Conference sessions emphasized that unifying data, leveraging predictive analytics, enabling real-time care coordination, and actively engaging patients are essential strategies for driving meaningful population health outcomes.

Bridge's EHR-agnostic architecture allows ACOs to turn raw data into actionable insights, improving care decisions and enabling teams to proactively manage patient populations. Bridge empowers our customers to identify high-impact care opportunities and improve outcomes organization-wide

AI and Automation in Value-Based Care

AI dominated the conversation, with countless agents and platforms promising transformation, but few offering real-world case studies. One session during the conference highlighted a medication management solution powered by agentic AI. While AI continues to be a hot topic in healthcare, many organizations reported being stuck in the pilot phase, struggling to translate promising technologies into scalable solutions.

At The Garage, we believe in applied intelligence, which combines advanced technologies like machine learning, predictive analytics, and agentic AI with human expertise to solve practical challenges in care delivery. The Garage's Blaze Agents don't just automate tasks; they act as intelligent collaborators. Our agents showcase insights from the EMR, initiate outreach, optimize reimbursement, and support documentation at the point of care. This framework ensures that technology enhances, not replaces, the human connection in healthcare. By leveraging applied intelligence, we are helping organizations reduce burden, improve outcomes, and empower their care teams.

The results speak for themselves:

• BlazeSync saves care managers 6-7 hours daily on outreach and follow-ups, with an estimated $5M annual cost savings per 1,000 high-needs patients and $300K in new revenue.
• BlazeLink helps rural providers recover $3M-$8M annually in lost contract reimbursements and optimize 340B by recovering $500K-$10M annually in unclaimed prescription revenue and $100-$300 margin per 340B-eligible prescription.
• BlazeSpeaks, our point-of-care intelligence agent, saves 12 hours/month per provider on chart chasing, coding, and data retrieval, $50,000 per 1,000 patients in avoided ER visits, readmissions, and better care coordination.
• ...and much more!

Financial Sustainability and Risk Readiness

A recurring theme was the ongoing challenge ACOs face in managing downside risk, thin margins, and multi-payer contract readiness. As ACOs increasingly manage overlapping contracts, including commercial, Medicare Advantage, and MSSP, unified financial insight is essential.

Bridge delivers that visibility. Our financial analytics and predictive insights help organizations navigate complex contracts, monitor performance, and plan strategically with confidence.

Post-Acute Care Optimization

Post-acute strategy emerged as one of the fastest levers to reduce total cost of care under TEAM and AHEAD. Discussions focused on optimizing care transitions to improve outcomes, enhance patient satisfaction, and strengthen network performance.

Bridge enables ACOs to identify high-cost patients and streamline transitions, reducing readmissions, shortening stays, and maximizing post-acute efficiency.

Compliance, Quality, and Reporting Readiness

Navigating eCQMs, MIPS CQMs, and Medicare CQMs remains one of the most complex yet critical challenges for ACOs striving for high performance. It was a central theme during the conference.

Bridge helps ACOs overcome these hurdles by streamlining quality reporting through ONC-certified dashboards that support QRDA exports, automate compliance, and integrate seamlessly with over 127 EHRs and 80% of payers. This enables care teams to access real-time, all-payer data across patient populations, reducing manual abstraction and improving reporting accuracy.

Looking Ahead: Scaling Impact in 2026

While NAACOS provides opportunities to connect with partners and exchange bold ideas about the future of value-based care, this year's conference highlighted the promise and complexity facing ACOs, particularly due to CMS's absence during the government shutdown, which left a leadership gap at a critical time. Behavioral health took center stage, with growing interest due to upcoming models. Organizations emphasized the need to turn strategy into action as they look ahead to 2026.

Whether we connected at NAACOS or we missed the chance to meet, we're excited to keep the conversation going. With our 2026 ACO Operational Framework, we help ACOs navigate this complexity, strengthen interoperability, and embed governance in their day-to-day operations. Let's work together to scale your impact in 2026 and beyond.