ACOs are 'the best way to deliver health care,' CMS chief Dr. Oz says

Accountable care organizations (ACOs) are the best way to deliver health care, the nation's Medicare chief said.

Now federal health leaders and ACO participants must join to recruit practices that are not in an accountable care model.

Centers for Medicare & Medicaid Services Administrator Mehmet Oz, M.D., MBA, delivered a keynote address for the fall 2026 conference of the National Association of ACOs (NAACOS). Oz spoke a recorded interview with NAACOS President and CEO Emily Brower, MBA.

"Yes, without question, and I am more confident that ACOs, being in an accountable care relationship in general is the best way to deliver health care. It's much better than the fragmented, often dysfunctional fee-for-service models that are the alternative," Oz said.

Last year, Medicare returned about $4 billion to providers in accountable care relationships, and those ACOs probably saved the government $2.5 billion, Oz said. Higher-quality physicians tend to join because they already think that way, he said.

"The bottom half of the quality pyramid is harder for us to engage. Again, they don't think that way," Oz said. "And if we can get that group to move into an accountable care relationship, it would be a home run for the American people and for our nation."

Can technology be 'ACO lite'?

The CMS Innovation Center's ACCESS Model is bringing technology companies off the sidelines for the first time, Oz said. Amy Gleason, leader of CMS' Office of Health Technology and Products, built a pledge that 900 companies signed, and more than 100 of them are building tools launched with ACCESS for conditions such as diabetes and hypertension, he said. The model pays only when outcomes improve, such as a patient's hemoglobin A1C level.

"All I care about is did their A1C drop because they were struggling with that issue, and you promised you'd help," Oz said.

For a primary care physician who lacks time to join an ACO, such tools could link the practice with specialists and the patient, a step Oz called "ACO lite."

NAACOS members already use patient-facing apps, remote monitoring and artificial intelligence, and they are watching ACCESS for tools that fill gaps without disrupting the care coordination they built, Brower said. Medical Economics has reported on what the model means for primary care.

"So partnership in ACCESS is critical. That's what our members are telling us," Brower said.

Why treat obesity earlier?

Oz cited the Medicare GLP-1 Bridge, which offers glucagon-like peptide-1 (GLP-1) medications to people who are overweight and at high risk of chronic disease. CMS expects to reduce complications and payments within two years, he said.

"Two-thirds of all the money that I spend, your money, your taxpayer dollars, is being spent for chronic illnesses, many of which are addressable," Oz said.

The U.S. obesity rate is 43%, compared with about 5% in Japan, Oz said. The nation will not reach 5%, but people can reach a "playing weight" where they feel well, sleep better and walk without discomfort, he said. If healthier Americans retired at 63 instead of 62, the extra year of work would add $1 trillion a year to the economy, he said.

How do ACOs spot fraud?

ACOs are "an early warning signal" for problems such as fraud involving skin substitutes, Oz said. Medicare Advantage plans use prior authorization, but traditional Medicare does not, so ACOs were held accountable for costs they could not control. Fraud, waste and abuse total about $100 billion a year, and CMS has stopped $42 billion in Medicare this year, he said.

Brower said patients brought members bills for services nobody ordered. One member drove to the billing provider's address and found a Mail Boxes Etc. store.

"It makes them crazy. It makes us crazy as NAACOS," Brower said.

Rural health in the spotlight

Oz pointed to the $50 billion Rural Health Transformation Program, which he described as an investment in care in rural America. CMS is putting the money out "not to pay the bills today," because a program that large is not meant simply to help rural providers catch up, he said. The goal is to transform the system.

Brower said CMS staff had discussed subsidiarity with NAACOS members, and Oz said the concept, borrowed from the hierarchy of the Catholic Church, guides both ACOs and the rural program. The lowest-ranking person able to make a decision should make it, he said. For that reason, CMS gave the rural funding to governors, who know far more about their rural communities than federal officials do, Oz said. Their needs also vary widely, he added, comparing the health conditions of people living on Alaska's North Slope with those of lower Alabama. Both have struggled to keep up with the rest of the country, which is why life expectancy in rural America is almost three years shorter than in urban America, Oz said.

What comes next?

CMS also wants ACO benchmarks "that we grade you with" to rely less on last year's numbers and more on "what's happening in the environment around you," Oz said.

"We are better if we work together. ACOs are the tip of the spear when it comes to better quality care. We're doing our best to make it easier to join an ACO," Oz said.