Women’s Health Briefing. A4H, in partnership with United States of Care and the National Partnership for Women and Families, hosted a virtual briefing titled “Advancing Women’s Health through Innovation and Payment Reform.” The audience included congressional staff and stakeholders. The briefing highlighted how value-based care can advance women’s health through better care coordination for cancer screenings and maternal health, among other services. The panel of experts discussed existing models focused on women’s health and current gaps where accountable care can play a role in strengthening health outcomes. You can download the recording here.

Bipartisan Lawmakers Ask House Leadership to Address Physician Pay Cuts. A letter signed by 233 bipartisan members of the House of Representatives addressed to House Speaker Mike Johnson (R-LA) and House Minority Leader Hakeem Jeffries (D-NY) urges leadership to consider both long-term and short-term solutions to the proposed Medicare physician reimbursement cuts in the 2025 Medicare Physician Fee Schedule proposed rule. The letter encourages action to both prevent the rate cuts in the proposed rule and address the uncertainty and instability clinicians face, as well as the increasing costs of compliance with the Merit-Based Incentive Payment System (MIPS). The letter also expresses the lawmakers’ desire to pass payment reform legislation. A4H submitted comments on the Physician Fee Schedule proposed rule and we continue to work with lawmakers to push them to mitigate cuts this year and consider additional actions to strengthen accountable care moving forward.

CMS Spotlights Patient & Provider Stories Illustrating the Benefits of Value-Based Care. The Spotlight offers educational materials on the basics of value-based care for providers, patients, and the public. The site highlights patient and provider stories on home kidney treatment, health-related social needs, and the Pennsylvania Rural Health Model’s integrated and person-centered care successes. CMS also released a story highlighting a primary care physician’s experience in ACO REACH, demonstrating the impact of case managers who support patients and help reduce provider burnout. A4H is glad to see CMS continue highlighting the success of accountable care – for patients, providers, and the broader health system. We look forward to continued work with CMS and other stakeholders to advance accountable care.

CMS Seeks Feedback on Medicare $2 Drug List Proposal. The proposal, which would provide Medicare beneficiaries in participating Part D plans with fixed-cost access at $2 or less for a month’s supply of certain drugs, would be voluntary for plan sponsors and could start as early as January 2027. CMS also requested feedback on a proposed list of drugs for the program. We continue to work with the CMS Innovation Center on model design and efforts to advance accountable care.

CMS Announces MA and Part D Star Ratings. CMS released the MA and Part D Star Ratings program results. The rating system is updated annually and measures the quality of health and prescription drug services received by enrollees in MA and Part D plans (PDPs). This year, approximately 40 percent of MA-PD contracts received four or more stars, down from about 44 percent in 2024, and 51 percent in 2023. Based on updated cut points, several larger plans saw significant decreases in their star ratings.

Health Affairs Forefront Article on Physician Payment Reform in Medicare. In the latest installment of HA’s Accountable Care for Population Heath series, the article discusses the fundamental role of alternative payment models (APMs) in transforming health care delivery and payment and the importance of the APM bonus in creating a payment differential between APMs and fee-for-service. The author, Michael McWilliams recommends restructuring the APM bonus from the current bonus tied to revenue to a per-beneficiary payment using an ACO-like attribution process for determining which provider receives the bonus. He also discusses the importance of a comprehensive approach to primary care payment reform, as opposed to current, piecemeal strategies. A4H likewise continues to advocate for a per-beneficiary bonus structure that strengthens the incentives to participate in accountable care and to discuss the importance of comprehensive approaches to primary care payment that align with total cost of care strategies.

A4H Double Click on Accountable Care. Join us on Thursday, December 12, at the Kaiser Center for Total Health (700 2nd St, NE, Washington, DC) for our next Double Click event. This event will feature sessions looking to 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. You can register for the event here.

Save the Date A4H @ Health Care Value Week. Join A4H on Tuesday, 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 health care delivery reform. You can register for the event here.