The 2025 NAACOS Spring Conference brought together leaders across accountable care organizations (ACOs), health systems, payers, and technology innovators at a pivotal moment for value-based care (VBC).
The conference highlighted a growing urgency: how to evolve payment models, scale operational excellence, adapt to growing demands for personalized, convenient care, and navigate mounting financial pressures — all while staying true to the core mission of better, more sustainable patient care.
Pearl Health was proud to contribute to the conversation, with two of our team members participating in expert panels and our broader team hosting energizing early-morning events — including a 5K walk and 10K run — that brought value-based care leaders together outside the conference halls to promote health, build community, and spark informal conversation before the day began.
Here are some of the major themes and insights from the week:
1. National Models Are Not Enough:
The Need for Localized Innovation
Leaders across sessions echoed a common refrain: current national frameworks like the Medicare Shared Savings Program (MSSP) aren’t flexible enough to support the unique needs of local and rural care organizations.
There was a strong call for locally rooted, population-health-focused models that allow for more nuanced approaches to care delivery and performance measurement. Many noted that standard cost and quality metrics unfairly penalize groups managing frail, elderly, or otherwise complex populations — and that tailored benchmarks and carveouts are urgently needed.
2. Provider Success Hinges on Simplicity and Support
- Provider success teams, including on-site pharmacists
- Centralized scheduling support for Annual Wellness Visits (AWVs)
- Remote nurses and ED navigation coordinators
- Embedded financial and quality analysts to enable data-driven care planning
3. Operational Infrastructure Defines
Value-Based Success
While AWVs remain an important driver of quality scores and patient engagement, many providers view them as a burden unless scheduling and outreach are operationalized centrally.
Similarly, transitional care management programs and emergency department navigation roles were highlighted as cost-saving strategies that reduce readmissions and unnecessary utilization.
The bottom line: value-based care success is increasingly defined by operational precision, not just strategic intent.
4. Relationships and Community Are Central
to Value-Based Care Transformation
Beyond models and technology, the conference reinforced that strong relationships and trust are foundational to success in value-based care.
Building collaborative partnerships among providers, payers, and enablers will be critical as financial and operational demands continue to rise.
Reflecting this spirit of connection, Pearl Health’s Michael Dudley led a 5K Sunrise Walk and a 10K Sunrise Run, bringing together dozens of healthcare leaders for early-morning conversations and fresh perspectives. These informal moments highlighted a shared commitment to driving change — together.
5. The Next Frontier of AI in Primary Care
While AWVs remain an important driver of quality scores and patient engagement, many providers view them as a burden unless scheduling and outreach are operationalized centrally.
Similarly, transitional care management programs and emergency department navigation roles were highlighted as cost-saving strategies that reduce readmissions and unnecessary utilization.
The bottom line: value-based care success is increasingly defined by operational precision, not just strategic intent.
6. Capitation and Prospective Payment Models:
Opportunity and Complexity
- Capitation can unlock flexibility and cash flow, and when structured appropriately other payment mechanisms (e.g. advances on shared savings) can incentivize proactive care more effectively than retrospective reconciliation.
- Primary care capitation under ACO REACH offers significant benefits, but clarity around which services are included is essential to avoid confusion.
- Claims reduction files that show physicians their FFS versus capitation outcomes are an important tool for building buy-in.
7. Nuanced Payment Model Considerations:
MSSP vs. REACH
- Benchmarking years under REACH were described as more favorable for many groups.
- Concerns were raised about the Accountable Care Prospective Trend (ACPT): a potential headwind in MSSP but a tailwind in REACH.
- REACH allows greater attribution flexibility, making it a strong option for ACOs with high NPI/TIN turnover.
- Challenges around specialty performance within TINs were also discussed, with REACH offering options for selectively removing NPIs from performance calculations.
8. Actuarial Insights Are a Strategic Imperative
- ACOs must understand their trend assumptions and monitor performance closely over time to avoid underperformance relative to model expectations.
- Timely data, including ADT (Admission, Discharge, Transfer) feeds, is essential for real-time visibility into patient movement and risk.
- MSSP benchmark resetting opportunities are often overlooked but can be a critical lever for groups struggling to see savings.
9. Addressing Behavioral Health to
Unlock ACO Transformation
Behavioral health is no longer a secondary concern in value-based care — it’s a foundational pillar.
In a panel discussion featuring Pearl Health’s Dr. Beau Muñoz, alongside leaders from Total Life, Palm Beach ACO, and Delaware Valley ACO, speakers shared how embedding behavioral health strategies — including proactive screening during AWVs — can improve chronic disease management, reduce emergency department utilization, and drive higher patient satisfaction scores.
Integrating behavioral health is increasingly seen as mission-critical for ACO success: research suggests it can significantly improve population health outcomes and help ACOs thrive under cost benchmarks.”
Approximately 68% of those with behavioral health issues have comorbid physical conditions, typically chronic conditions such as asthma, low back pain, and diabetes. Mental heatlh patients with additional chronic comorbidities are 2x more likely to be hospitalized and have a 41% increase in all cause mortality.1
When Kaiser Sacramento integrated medical and substance use treatments in primary care clinics for individuals in an outpatient chemical dependency recovery program, per-member-per-month (PMPM) costs dropped more than 50%, with significant declines in hospitalization rates, inpatient days, and emergency department use.The message was clear: addressing behavioral health needs is essential for achieving both clinical and financial performance goals in VBC models.2
10. Specialists Remain an Untapped Opportunityin VBC
While primary care remains central to VBC strategies, several speakers noted that specialists have been underutilized in performance improvement initiatives.
Future success will require broader engagement and integration of specialists into care coordination, quality improvement, and cost management strategies.
Shaping the Future, Together
The 2025 NAACOS Spring Conference made one thing clear: the future of value-based care will be shaped not just by new models and technologies, but by those who pair innovation with operational excellence, strategic actuarial insight, and deeper integration of behavioral and specialty care.
At Pearl, we’re seeing this shift play out daily — transformation happens when complexity is stripped away, data becomes actionable, and relationships are strengthened across the care continuum. The leaders who embrace simplicity, empower frontline teams, and stay rooted in community needs will define what comes next.
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- http://www.nasmhpd.org/content/morbidity-and-mortality-people-serious-mental-illness. Published 2006. Accessed August 26, 2016.
- Minkoff, Niel, Treating Behavioral Health Disorders in an Accountable Care Organization, Population Health, Equity & Outcomes, December 2016, Vol 4, Issue 4.
