This legislation aims to improve the method of assigning beneficiaries to Accountable Care Organizations (ACOs) under the Medicare Shared Savings Program . Currently, beneficiary assignment is primarily based on services provided by physicians. The bill expands this by recognizing primary care services delivered by other qualified healthcare professionals. Specifically, for performance years starting on or after January 1, 2026 , the assignment process will also consider primary care services furnished by nurse practitioners , physician assistants , and clinical nurse specialists . This amendment to the Social Security Act seeks to more accurately reflect the primary care relationships beneficiaries have with a broader range of providers, thereby strengthening the ACO model.