Washington, D.C., December 14, 2023 — Following the introduction of the Value in Health Care Act in the U.S. Senate this week, Accountable for Health (A4H) announced its strong support for the legislation and its efforts to accelerate the adoption of accountable care models across the country. The bipartisan bill is sponsored by Sheldon Whitehouse (D-RI), John Barrasso (R-WY), Peter Welch (D-VT), Thom Tillis (R-NC), Bill Cassidy, M.D. (R-LA), John Thune (R-SD) and Marsha Blackburn (R-TN). The legislation would improve care quality and reduce health care costs by incentivizing participation in Accountable Care Organizations (ACOs), specifically through a two-year extension of the advanced APM incentive payments for participating providers. A4H CEO Mara McDermott issued the following statement:

“Senate introduction of the Value in Health Care Act comes at a critical moment in the advancement of high-quality, whole-person accountable care as the current 3.5% AAPM incentive payment to providers is set to expire at year’s end,” said McDermott. “Fee-for-service care is entrenched in American healthcare, rewarding providers for a high volume of services rather than detail-oriented person-centered care that focuses on quality outcomes. Lowering the barriers to entry for ACO participation is the first and necessary step to realizing better care coordination, more accessibility, and improved health outcomes for the growing population of Medicare beneficiaries. This is an important signal from lawmakers showing momentum behind—and long-term support for—accountable care models.  If enacted, it will help many new providers reach and improve the lives of more American seniors.”

The Value in Health Care Act would make the following changes to improve health outcomes for seniors while lowering costs:

  • Incentivize participation in Advanced APMs by extending the annual lump sum participation bonus at 5% for an additional two years.
  • Correct arbitrary thresholds for Advanced APM qualification to better reflect the existing progress of the value-based movement and to encourage bringing more patients into this model of care.
  • Establish guardrails for CMS to ensure that the process to set financial benchmarks is transparent and appropriately accounts for regional variations in spending to prevent arbitrary winners and losers.
  • Remove barriers to ACO participation by eliminating arbitrary program distinctions so all participants are participating on a level playing field.
  • Support fair and accurate benchmarks by modifying performance metrics so participants aren’t competing against their own successes in providing better care.
  • Provide greater technical support to ACO participants to cover the startup costs associated with program participation.

About Accountable for Health

Accountable for Health (A4H) is a 501(c)(4) national advocacy and policy analysis organization accelerating the adoption of sustainable, effective accountable care that improves health care quality and outcomes and lower costs. We represent a broad, diverse group of accountable care stakeholders working to improve the way health care is delivered to people across the county, across various payers, programs, and delivery models. A4H provides advocacy, research, and education to improve outcomes and patient experiences while lowering costs.

For more information, visit https://accountableforhealth.org/. Follow us on LinkedIn and Twitter (@acct4health). ###


Related Posts

  • A4H Statement on New Primary Care Flex Model

    Today the Centers for Medicare & Medicaid Services (CMS) Innovation Center introduced ACO Primary Care Flex, a new accountable care organization model, to provide incentives for health care providers to transition from fee-for-service delivery to accountable care models that prioritize patient care and outcomes.

  • New Research Highlights the Important Role of Incentives to Accelerate the Transition from Costly Fee-For-Service to Value-Based Care that Prioritizes Quality Health Outcomes

    Today, Berkeley Research Group (BRG) published a new report, “Transitioning to Value-Based Care: Financial Implications for Providers and Policymakers,” in partnership with Accountable for Health (A4H).

  • A4H Statement on Recent APM Bonus Proposals

    Accountable for Health appreciates recent Congressional attention to the expiring 3.5% incentive payment for clinicians participating in advanced alternative payment models (APMs). Advanced APMs have been working for over a decade to improve care delivery and lower costs.