When your patients turn 65, will they automatically be enrolled in a Medicare Advantage plan or accountable care organization (ACO)? That idea is now on the Trump administration's radar.
CMS is currently mulling a plan that would automatically enroll beneficiaries into either Medicare Advantage plans -- in which private insurers contract with CMS to serve Medicare beneficiaries -- or ACOs, such as those that participate in the Medicare Shared Savings Program, according to a report in STAT.
Currently, people who don't make a choice are enrolled in traditional Medicare, which offers seniors the opportunity to see any doctor that takes Medicare; however, traditional Medicare is not the option favored by the Trump administration. Would auto-enrollment in either an ACO -- which is financially incentivized to provide more efficient care at a lower cost -- or Medicare Advantage be better than fee-for-service (FFS) Medicare, "where there's not this long-term, secular relationship between the beneficiary, the patient, and their provider? Yes," Chris Klomp, director of CMS's Center for Medicare, said in the STAT interview.
Republicans argue that Medicare Advantage, with its smaller physician networks and stricter prior authorization rules, can save the Medicare program money. But a report by the Medicare Payment Advisory Commission (MedPAC) in March 2026 found that Medicare paid $76 billion more for Medicare Advantage patients in 2025 than it would have if those same patients had been enrolled in traditional FFS Medicare.
