In this series, Dr. Dan Mingle explains key components of the 2026 Proposed Rule from the Centers for Medicare and Medicaid Services. The videos below cover:

• Medicare’s rulemaking process and how to share your comments on the 2026 Proposed Rule
• Changes to the Merit-based Incentive Payment System (MIPS) in the 2026 Proposed Rule
• Changes to MIPS Value Pathways (MVPs) in the 2026 Proposed Rule
• Changes to the Medicare Shared Savings Program (MSSP) in the 2026 Proposed Rule

Click play on any of the videos below to hear Dr. Mingle’s comments on the Proposed Rule, and please share your thoughts or questions in an email to hello@minglehealth.com or our Contact Us page here.

Part 1: Medicare’s Rulemaking Cycle Explained

In this video:

• Dr. Mingle explains the rulemaking cycle and where to find documents related to the 2026 Proposed Rule.
  • Comments on the Proposed Rule are due by September 12, 2025.
    • You can leave your comment on the Federal Register website here.
  • The 2026 Final Rule is expected to be released in early November 2025.

Part 2: MIPS and APM Proposals for 2026

In this video:

• Dr. Mingle explains proposed changes to MIPS and APMs in the 2026 Proposed Rule.
  • Category weights for MIPS are explained along with information about the MIPS Performance Threshold and Data Completeness Threshold.
  • Changes to the MIPS Quality measure inventory are explained, along with proposed changes to the Cost, Improvement Activities, and Promoting Interoperability categories.
  • For Alternative Payment Models, Dr. Mingle explains a proposed change in how Qualified Participant (QP) status is determined.

Part 3: MSSP Proposals for 2026

In this video:

• Dr. Mingle explains proposed changes to the Medicare Shared Savings Program (MSSP) in the 2026 Proposed Rule.
  • The Proposed Rule would allow new ACOs to participate in a one-sided risk model for no more than five years.
  • CMS suggests retiring the Health Equity Bonus for ACOs for the 2025 Performance Year and onward.
  • Extreme and Uncontrollable Circumstances (EUC) rules for ACOs would be expanded to include cyberattacks.

Part 4: MIPS Value Pathways (MVPs) Proposals for 2026

In this video:

• Dr. Mingle explains proposed changes to MIPS Value Pathways (MVPs) in the 2026 Proposed Rule.
  • Changes to Mandatory Subgroup Reporting for MVPs are explained along with rules for small practices and large multi-specialty groups.
  • New MVPs are discussed along with registration deadlines and specialty attestation rules when registering for an MVP.

Part 5: Medicare’s New Ambulatory Specialty Model

In this video:

• Dr. Mingle explains the newly proposed Ambulatory Specialty Model (ASM) in the 2026 Proposed Rule:
  • The ASM will be an initial five-year trial through the Center for Medicare and Medicaid Innovation (CMMI).
  • Scoring in this model will vary from traditional MIPS, with different weighting for Quality and Cost and different treatment of Promoting Interoperability and Improvement Activities.
  • The ASM will focus on two high-cost chronic conditions: Heart Failure and Chronic Low Back Pain, and the specialists who provide care for these conditions.
  • Communities will be selected for the program based on statistical areas defined by the Office of Management and Budget, and will be stratified by cost and volume.

Send us your value-based care questions!

If you’d like to ask a question about the APP transition, MIPS, ACO quality reporting, or any other Alternative Payment Model, you can reach out to us in three ways:

You can leave your questions in a YouTube comment under any episode of Ask Dr. Mingle.

On LinkedIn, leave your questions in a comment on any of our posts.

And you can reach out directly by sending an email to hello@minglehealth.com.

Want to learn more about quality reporting for ACOs in 2025?

Our PDF guide provides critical information for MSSP ACOs as they tackle new quality reporting requirements for the 2025 Performance Year.

Get the Guide