Peoria Standard

Over 600 healthcare organizations, including health systems, hospitals, physician practices, health clinics, and Accountable Care Organizations (ACOs), have expressed their support for the Value in Health Care Act. This legislation, introduced by U.S. Representatives Darin LaHood and Suzan DelBene, aims to make changes to Medicare's Alternative Payment Models (APMs) to encourage participation in ACOs and improve services for seniors and their families.

In a letter, the stakeholders emphasize their strong endorsement of the bipartisan bill and stress the importance of passing key provisions before the end of the year. Representatives LaHood and DelBene affirm that the Value in Health Care Act is a "commonsense proposal" that includes necessary reforms to promote greater involvement in ACOs and ultimately enhance the quality of care and health outcomes for seniors.

The stakeholders' letter highlights two significant policy changes proposed by the legislation. First, it includes a two-year extension of the 5 percent advanced APM incentives provided by the Medicare Access and CHIP Reauthorization Act (MACRA). This extension aims to encourage the transition to advanced APM arrangements and gradually increase the revenue qualifications for incentive payments.

Second, the Value in Health Care Act seeks to address the revenue qualification thresholds for participation in APMs. By adjusting the one-size-fits-all approach, the legislation aims to ensure that physicians and other clinicians can continue to participate in APMs. This change will facilitate the ongoing transition to advanced APMs and enable more patients to benefit from this model of care.

Representatives LaHood and DelBene were joined by several other lawmakers in introducing the Value in Health Care Act. The legislation proposes several changes to the APM and ACO parameters, including:

- Extending MACRA's 5 percent advanced APM incentive payments for two years to encourage the shift towards value-based care.

- Establishing guardrails for the Centers for Medicare and Medicaid Services (CMS) to transparently set financial benchmarks that consider regional variations in spending, preventing arbitrary winners and losers.

- Removing barriers to ACO participation by eliminating arbitrary program distinctions, ensuring a level playing field for all participants.

- Modifying performance metrics to support fair and accurate benchmarks, preventing participants from competing against their own successes in providing better care.

- Extending the annual lump sum participation bonus for an additional two years to incentivize participation in Advanced APMs.

- Correcting arbitrary thresholds for Advanced APM qualification to better reflect the progress of the value-based movement and encourage the inclusion of more patients in this care model.

With broad support from healthcare organizations, the Value in Health Care Act aims to incentivize value-based care and improve healthcare outcomes for seniors. The legislation's proposed changes to APM and ACO parameters seek to create a more inclusive and transparent healthcare system that prioritizes coordinated and comprehensive care. As Congress approaches the end of the year, passing this bipartisan legislation is crucial to expanding access to quality healthcare for all.

To learn more, click on this link: https://lahood.house.gov/2023/10/lahood-delbene-legislation-to-incentivize-value-based-health-care-receives-expansive-support