WASHINGTON, D.C. – Today, U.S. Senators John Barrasso (R-Wyo.) and Sheldon Whitehouse (D-R.I.) introduced bipartisan legislation to expand access to quality-driven health care. The ACO Assignment Improvement Act expands participation in Medicare’s coordinated-care programs by ensuring Medicare recognizes the care patients receive from nurse practitioners, physician assistants, and clinical nurse specialists when determining their participation in an Accountable Care Organization (ACO). This change will help Medicare patients receive more seamless, coordinated, and high-quality care.
“As a doctor from a frontier state, I am committed to making sure patients can access high-quality health care no matter where they live,” said Barrasso. “This bipartisan legislation supports the providers patients rely on every day. By expanding Accountable Care Organizations to include more providers, we can help lower costs and make care easier for patients to navigate.”
“Rhode Island’s accountable care organizations continue to improve patient care while lowering costs,” said Whitehouse. “Many Rhode Islanders see nurse practitioners and physician assistants for their primary care. With our bipartisan bill, these same patients will now have access to care from providers rewarded for patient health outcomes.”
“The American Association of Nurse Practitioners (AANP), on behalf of the over 461,000 nurse practitioners (NPs) nationwide, commends Senators Barrasso and Whitehouse for their leadership on the ACO Assignment Improvement Act of 2025”said, AANP President, Valerie J. Fuller, PhD DNP. “The importance of passing this legislation has continued to grow as more patients are seeing NPs, and over half of NPs in Medicare participate in the Medicare Shared Savings Program. NPs are essential in the transition to value-based care, and removing this barrier will increase patient access to accountable care and improve on the success of the program.”
“ACOs help ensure Medicare patients, especially the chronically ill, receive coordinated, high-quality care. As clinicians who serve as primary healthcare providers, PAs often participate within ACOs. This critical bipartisan legislation will ensure patients receiving care from a PA will benefit from participation in an ACO,” said AAPA President Todd Pickard, DMSc, PA-C, DFAAPA, FASCO.
Background:
Accountable Care Organizations (ACOs) are groups of hospitals, doctors, and other health care providers who work together to coordinate care for patients. ACOs are a proven model that improves care coordination and quality. According to the Centers for Medicare & Medicaid Services (CMS), ACOs saved the Medicare program approximately $2.4 billion in 2024—the eighth consecutive year of net savings—by delivering high-quality, coordinated patient care.
For many Americans—especially those living in rural communities—their closest and most consistent primary care relationship is with a nurse practitioner (NP) or physician assistant (PA). However, current Medicare rules typically assign patients to an ACO only if they receive primary care from a physician. The ACO Assignment Improvement Act updates this policy to ensure that patients who rely on NPs, PAs, and clinical nurse specialists for primary care can participate in the ACO model alongside those who see physicians.
The bill reinforces the longstanding relationships patients have with their trusted primary care providers by allowing ACO assignment based on visits with these clinicians. This change expands access to the coordinated, high-quality care that ACOs are designed to deliver.
###