The House and Senate are in recess and will return next week.

A4H Joins Stakeholder Letter to Congressional Leadership Urging APM Bonus Extension by End of Year. A4H, together with other stakeholders, sent a letter to congressional leadership urging lawmakers to include an extension of Medicare’s Advanced Alternative Payment Model (APM) incentives and an update to scheduled cuts to Medicare’s physician payments in an end-of-year health care package. The letter highlights how accountable care models have saved more than $28 billion for Medicare over the past decade. The stakeholders noted that while progress has been made, annual payment cuts and rising costs due to inflation may dissuade providers from participating in accountable care models moving forward, ultimately impacting patients’ access to care. While it remains to be seen whether lawmakers will agree on a broader health care package before the end of the year, A4H continues to push Congress to mitigate physician pay cuts and maintain momentum for APMs.

CMS Releases Medicare Advantage and Part D Technical Rule. The Centers for Medicare & Medicaid Services (CMS) released a proposed rule including coverage of anti-obesity medications under certain circumstances, strengthening prior authorization and utilization management guardrails, proposing guardrails for artificial intelligence, improving access to behavioral health benefits, proposing requirements around supplemental benefits coverage through debit cards, updating medical loss ratio reporting requirements; and improving experiences for dual eligible enrollees. The fact sheet is available here and the proposed rule is available here.

CMS Innovation Center Reimagines Rural Care. The CMS Innovation Center recently published the Re-imagining Rural Health: Themes, Concepts, and Next Steps for the CMS Innovation Center “Hackathon” Series. The report identifies lessons from past Innovation Center models, emphasizing the need for rural-tailored designs, enhanced provider participation, and better integration of services. It applies these insights to current models by prioritizing flexibility and simplifying requirements for rural providers. Potential areas for exploration include addressing workforce shortages, expanding telehealth, improving care coordination, and increasing access to behavioral health services. To build on these lessons, CMS intends to issue a Request for Applications to fill ten open spaces for the Rural Community Hospital Demonstration. We expect accountable care for rural communities to remain an area of bipartisan interest heading into 2025 and beyond.

Article Highlights Opportunities to Enhance ACO REACH. A recent Health Affairs article highlights how certain elements in ACO REACH, including prospective capitated payments, global risk-sharing, and equity-focused measures, have increased quality and cost-efficiency in Medicare. The article also notes that some challenges remain around benchmarking complexities, data access, and administrative barriers for smaller providers. The Duke Margolis authors urged CMS to provide clarity for ACO REACH’s future. A4H likewise has emphasized the importance of continuity for beneficiaries and model participants.

American Heart Association Study Shows ACOs Provide Better Care for Patients and Better Practice Experiences for Health Care Teams than Fee-for-Service. The American Heart Association interviewed patients, caregivers and care team members, capturing diverse viewpoints on accountable care experiences, particularly focusing on medically complex patients. The study highlights strong primary care relationships, care coordination, and a team based approach including care managers, social workers, and other professionals and enhanced patient engagement. In addition, patients cited additional resources, such as transportation, food, housing and financial assistance as elements of an accountable care system that support overall health. Materials developed from the study and a webinar reviewing the methods and findings are available here. Thank you to the A4H members who participated in this study. These findings support our work in Washington, DC, to expand effective accountable care.

A4H Double Click on Accountable Care. Register for our upcoming Double Click on December 12 at the Kaiser Center for Total Health (700 2nd St, NE, Washington, DC). This event will feature sessions on the 2025 accountable care agenda, including quality measurement, legislation impacting individuals dually eligible for Medicare and Medicaid, and the future of alternative payment models and the CMS Innovation Center. Register here.

Speakers include:

• Mara McDermott, CEO, Accountable for Health
• Josh Trent, Managing Principal, Leavitt Partners
• Joe Albanese, Senior Policy Analyst, Paragon Health Institute

Save the Date A4H @ Health Care Value Week. Join A4H on February 25 for an in-person event in Washington, DC, in conjunction with Health Care Value Week. The event will bring together organizations, stakeholders, and policymakers to discuss accountable care successes and the work ahead. Sessions will include Congressional, community, and provider perspectives on accountable care and the outlook for the future of healthcare delivery reform. You can see a list of confirmed speakers here. Register here and stay tuned for additional programming updates.