Accountable Care in 2027: Building the Evidence Base and Driving Practical Policy Solutions

As 2027 approaches, accountable care is entering a new phase of evolution. While the model has largely proven more effective than traditional fee-for-service payment, and few stakeholders question the need for greater accountability for cost and quality, there is less agreement on what comes next. Evidence shows accountable care can generate savings and improve population health under risk-based arrangements, yet important questions remain around provider incentives, data sharing, risk adjustment, specialty care integration, and the incorporation of high-cost therapies. Although the field has matured, it has yet to achieve consensus on the policies and infrastructure needed for sustained success or meaningfully bend the cost curve in ways that address affordability concerns.

At the same time, accountable care operates in a markedly different environment than when it emerged. Medicare Advantage now dominates enrollment, health systems continue to face financial strain, and technological advancements—including artificial intelligence, predictive analytics, digital health tools, and next-generation care management capabilities—are reshaping how organizations identify risk, engage patients, and manage populations at scale. These innovations create opportunities to improve outcomes and efficiency, while also enabling more rapid evidence generation through real-world data, pragmatic evaluation methods, and learning health system approaches. Together, these capabilities can help accelerate the translation of innovation into practice and inform more responsive policymaking. However, ongoing debates over program design features, transformative therapy coverage, and the like continue to challenge sustainability of participation and scaled transformation.

The outlook for 2027 remains optimistic, but mission critical challenges persist. Accountable care is now a permanent part of the Medicare landscape, yet its future impact will depend on policymakers’ ability to modernize the data, technology, and payment infrastructure that supports it. The next phase may be defined not by voluntary expansion, but by the permanent adoption of evidence-based approaches that can be rapidly tested, refined, and scaled across the health care system. Hear from policy experts and experts in the field about progress to date and opportunities to leverage evidence to accelerate accountable care.

This event is part of the West Health Accelerator at Duke-Margolis, a collaborative initiative to strengthen Medicare accountable care, improve care for older adults, advance brain health, and integrate transformative therapies into care.