Both the House and Senate will return to DC on September 9.

When Congress returns, it will focus on keeping the government open by passing a short-term stop-gap funding bill before September 30. Congress will likely extend funding through December, setting the basis for a broader end-of-year package. To prepare for the end-of-year package, we anticipate key committees with jurisdiction over health care will begin releasing more details on physician payment reform legislation with both short—and long-term policy objectives. A4H continues to engage with these key committees and push them to mitigate physician pay cuts this year and consider additional actions to strengthen accountable care as lawmakers look to 2025.

CMS Releases Evaluation of Vermont All-Payer ACO Model. The model is testing how a state-specific, all-payer ACO program can incentivize broad delivery system transformation to reduce spending and improve health outcomes. The evaluation report looks at performance from 2018 through 2022. The evaluation shows that about half of eligible Vermonters were attributed to the model across Medicare, Medicaid and commercial payers. The model reduced gross and net total Medicare spending for attributed beneficiaries, reduced avoidable hospital utilization, and increased population health management capacity. CMS highlights agreement among stakeholders that the model has improved the acceptance of value-based care among providers. The full evaluation can be found here, and a summary of the findings can be found here.

Health Affairs Forefront Highlights Primary Care. The article “Out Of Balance: Fixing Our Health System’s Neglect Of Primary Care” cautions that current imbalances in the health care system are unsustainable due to an overreliance on acute care and points out that the highest-performing providers in Center for Medicare and Medicaid Innovation (Innovation Center) ACO models have a “strong base of primary care.” The article outlines several recommendations to restore balance, including paying primary care differently, increasing primary care spending, and improving the effectiveness of the clinician rate-setting process. The article points to the recent Senate Finance request for information on bolstering chronic care through physician payment and the PAY PCPs Act as potential vehicles to address the imbalances.

A4H Double Click on Accountable Care for Complex Populations. Join us on Tuesday, September 10 at the Kaiser Center for Total Health (700 2nd St, NE, Washington, DC) for our next Double Click event. You will hear from expert panelists on approaches to and perspectives on accountable care for complex populations. Topics include:

• CMS Innovation Center Models for Complex Populations: Current Portfolio and Future Landscape
• ACO Successes: Improving Care for Complex Populations
• Measuring Maternal and Infant Outcomes
• Congressional Outlook

Click here to register  |  Agenda available here