As 2025 comes to a close, CMS signals are becoming clearer across rural health, specialty care, chronic care, prevention, and accountable care. In this end-of-year episode, Coral Founder Meg Koepke is joined by Maria Alexander, Kate Freeman, and Trevor Abeyta to unpack what the latest federal models reveal about where policy and accountability are heading in 2026 and beyond. They discuss what RHTP signals about rural transformation, how ASM expands mandatory accountability into specialty care, what ACCESS shows about the future of digital chronic care, how LEAD reflects a shift toward longer-term accountable care, and why MAHA ELEVATE represents a new bet on prevention. Together, they reflect on what this mix of mandatory and voluntary models and fast experimentation with long horizons means for organizations preparing for the next phase of health care transformation.