Welcome to the Accountable for Health (A4H) newsletter, including legislative and Administration updates, accountable care news, and resources.

Health Care Value Week

Accountable for Health is pleased to work with over 60 stakeholder organizations to support Health Care Value Week, a week of action to support value-based care education and advocacy. We invite our members and friends to participate in the following Value Week events (please note separate registrations):

  • A4H and House Health Care Innovation Caucus: Innovation Showcase (in person) – on January 31, A4H members will have table top displays in the Rayburn Building and attendees are welcome to walk through the showcase between 11 am and 2 pm eastern (register here).
  • A4H @ Health Care Value Week (in person) – on February 1, A4H is hosting a half-day conference in Washington, DC, featuring panel discussions about accountable care. The agenda is available now (register here).
  • Virtual Value-Based Payment Summit. January 29-31 and February 2. The virtual conference agenda includes over 75 speakers on a variety of value-based care topics (register here).

To view a full schedule of Health Care Value Week events, visit: hcvalueweek.org.

Congressional News

The Senate and House will both be in session next week and are expected to continue to focus on government funding.

Government Funding and Health Care Legislative Outlook. On January 18, Congress passed another short-term funding extension, avoiding a government shutdown. This short-term package extends government funding through March 1 and March 8, giving the appropriations committees time to draft and negotiate the text of the individual spending bills. Lawmakers now have additional time to negotiate a broader health care package which could potentially pass alongside a funding bill. As we mentioned in previous newsletters, the House and Senate have advanced policies that would address hospital price transparency, pharmacy benefit manager (PBM) reforms, and site neutral payments. Both chambers also have advanced legislation to address the reduction to the Medicare physician fee schedule and extend the advanced alternative payment model (APM) bonus. A4H continues to work with Members of Congress to push for an extension of the APM bonus. The cost remains a concern and could impact the amount of the bonus, if extended. View the A4H table comparing APM bonus extension proposals here.

Administration

New Request for Information (RFI) seeks Feedback regarding Medicare Advantage (MA) Data, Including on Value-Based Care Arrangements. Stemming from the Biden Administration’s December announcement on Actions to Lower Health Care and Prescription Drug Costs by Promoting Competition, the Centers for Medicare & Medicaid Services (CMS) RFI solicits feedback on how data is collected and used for health care quality and outcomes, including value-based care arrangements, competition in the market, and beneficiary access in the MA program. The RFI is seeking input on existing data collection and on data that is not currently collected. A4H will be discussing the RFI with its members in the coming weeks, particularly as it relates to accountable care contracting in MA. Comments are due May 29.

CMS Announces New Innovation in Behavioral Health (IBH) Model. This new state-based model is intended to improve quality and health outcomes in Medicaid and Medicare populations with moderate to severe mental health conditions and substance use disorder (SUD). The model aims to integrate behavioral and physical health by supporting behavioral health practices as they coordinate care across different types of providers. Participants will range from Community Mental Health Centers, public or private practices, opioid treatment programs, and safety net providers that offer outpatient mental health and SUD services. CMS will release a Notice of Funding Opportunity in the spring. Up to eight states will be selected to participate. The model will launch in fall 2024 and will run for eight years. A4H members will have an opportunity to discuss this model at upcoming meetings.

Health Care Rewards to Achieve Improved Outcomes (HEROES) Program Aims to Improve Population Health. Advanced Research Projects Agency for Health (ARPA-H) announced a three-year program that will use a new outcomes based financing approach to pay organizations to improve population health. Organizations receiving funding will be referred to as “Health Accelerators.” The HEROES program is seeking feedback on outcomes for maternal health, opioid use disorder, alcohol-related impacts, and risk of heart attack and stroke; the program will ultimately select two outcomes for the final solicitation. The HEROES program homepage is available here. A4H is working with ARPA-H to better understand how HEROES complements the work of the CMS Innovation Center (described briefly in the New England Journal of Medicine article). A4H members interested in learning more about this program should be in touch with us so we can set up additional educational opportunities.

Four Things We’re Reading

  1. CMMI and Value-Based Care: Advancing and Safeguarding Primary Care (Health Affairs)
  2. Analyzing the Expanded Landscape of Value-Based Entities (HMA)
  3. Value-Based Care can Transform the Treatment of Patients with Substance Use Disorder (Health Affairs)
  4. Health Industry Reignites Debate over Mandatory Payment Experiments (Axios)

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