Seventeen healthcare stakeholder groups have come together to support The Value in Health Care Act, a bill that a bipartisan coalition reintroduced in Congress this summer. The bill supports a shift in the medical care industry from the current fee-for-service model to an accountable care model, which assigns compensation to medical providers based on health outcomes. Instead of incentivizing physicians to prescribe specific medications and tests during office visits, accountable care encourages physicians to independently spend time assessing their patients and receive compensation based on the outcomes of the care they provide.
The bill contains several improvements to the existing Centers for Medicare and Medicaid Services (CMS) value-based program, which led to its endorsement by multiple stakeholders. These improvements include the following:
- Two-year extension of the five percent alternative payment model incentives scheduled to expire at the end of the year, which were authorized by the 2015 Medicare Access and CHIP Reauthorization Act;
- Ability of CMS to adjust thresholds to secure incentive payments to benefit rural, underserved, primary care or specialty practices;
- Elimination of artificial revenue-based distinctions that disadvantage rural and safety net providers;
- Establishment of a more transparent process for setting financial spending targets for Accountable Care Organizations (ACOs);
- Creation of a voluntary track for ACOs who choose to take on higher levels of risk;
- Provision of technical assistance for clinicians new to Alternative Payment Models (APMs); and
- Authorization of studies designed to increase parity between APMs in traditional Medicare and Medicare Advantage.
The coalition of healthcare stakeholders, which includes the American Academy of Family Physicians, the American Hospital Association, and the American Medical Association, among others, submitted a letter of support for the bill. In its letter, the coalition noted that ACOs are the largest APM in Medicare, caring for over 13 million beneficiaries. ACOs have saved billions of dollars and improved the care for millions of patients over the last decade, and the bill would only further those cost savings and improvements in care.
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