Value in Health Care Act Seeks to Extend Medicare Payment Incentives for APMs
On July 27, 2023, the bipartisan Value in Health Care Act was introduced and seeks to extend the 5% Medicare payment incentives for advanced Alternative Payment Models (APMs) under the Medicare Access and CHIP Reauthorization Act (MACRA), which are due to expire at the end of the year.
The Value in Health Care Act was introduced by Reps. Darin LaHood, (R-IL); Suzan DelBene, (D-WA).; Brad Wenstrup, (R-OH); Earl Blumenauer, (D-OR); and Kim Schrier, (D-WA) to ensure that APMs continue to produce high-quality care for the Medicare program and its beneficiaries. The sponsors of the bill explained that value-based care programs have a successful track record of improving outcomes and reducing costs. Some APMs have helped to provide billions of dollars in savings for taxpayers in the past decade and accountable care organizations (ACOs) alone have saved Medicare more than $17 billion while improving quality. One of the problems, however, is that rules implemented to the ACO programs have limited the number of participating providers.
While the aim of MACRA was to speed up the transition to patient-centered, value-based care by encouraging physicians and other clinicians to transition into APMs, the transition has proven to be much slower than anticipated and more time is needed. Maintaining the incentives past the end of the year will help to bring more providers into value-based care models and expand access for beneficiaries. The Value in Health Care Act seeks to extend MACRA’s 5 percent advanced APM incentive payments for 2 years.
The Value in Health Care Act also gives the HHS Centers for Medicare & Medicaid Services (CMS) authority to adjust APM qualifying thresholds, remove revenue-based distinctions that disadvantage rural and safety net providers, establish a voluntary track for accountable care organizations in the Medicare Shared Savings Program to take on higher risk, and improve APM financial benchmarks.
“The Value Act ensures this investment in people’s health continues for two more years. Accountable for Health and its members look forward to working with Representatives LaHood and DelBene to advance this bill and continue transforming American health care away from fee-for-service toward high quality, accountable care,” said Mara McDermott, CEO, Accountable for Health.
