Reintroduced by Reps. Darin LaHood (R-Ill.), Suzan DelBene (D-Wash.), Brad Wenstrup, D.P.M. (R-Ohio), Earl Blumenauer (D-Ore.), Larry Bucshon, M.D. (R-Ind.), and Kim Schrier, M.D. (D-Wash.), it includes several improvements to CMS's existing value-based care programs. Among them:

It provides a two-year extension of the 5% advanced alternative payment model incentives created by the 2015 Medicare Access and CHIP Reauthorization Act that are scheduled to expire at the end of the year.
It authorizes CMS to adjust the thresholds to secure those incentive payments so that rural, underserved, primary care or specialty practices can benefit.
To improve access to care and address health equity, it eliminates the artificial revenue-based distinction that disadvantages rural and safety net providers.
It calls for a more transparent process to set financial spending targets for ACOs that were previously "penalized" for success.
It creates a voluntary track for ACOs to take on higher levels of risk.
It provides technical assistance for clinicians new to APMs.
It authorizes studies designed to increase parity between APMs in traditional Medicare and Medicare Advantage.

Commenting on these features of the bill, the letter of support said: "We are encouraged that the bill removes revenue-based distinctions that disadvantage rural and safety net providers, which is critical to improving access to care and improving health equity. The bill also improves financial benchmarks so that APM participants are not penalized for their own success. To allow more clinicians to continue the transition to value, the bill establishes a voluntary track for accountable care organizations in the Medicare Shared Savings Program to take on higher levels of risk, and provides technical assistance for clinicians new to APMs. Lastly, the bill seeks to explore the potential of providing parity between APMs and the Medicare Advantage program by studying ways to increase alignment that will ease burdens on physicians and ensure that both APMs and MA are attractive and sustainable options."

Instant Insights /

17 health care groups urge Congress to pass value-based care bill, extend 5% incentive

More From HR Executive

Related Stories

Recommended For You