Washington, D.C., November 14, 2023 — 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. Most recently, evidence from the Medicare Shared Savings Program and the Direct Contracting model show that people with Medicare coverage are benefiting from expanded access to services, better care coordination, and improved health care experiences, while also lowering federal healthcare spending.

Maintaining or improving on the current 3.5% MACRA bonus is critical to building on this success. This bonus has already been reduced from 5%. Further reduction will undermine provider migration to APMs and send a negative signal about the government’s commitment to accountable care models moving forward.

There is bipartisan agreement that fee-for-service reimbursement is at the root of some of the worst problems in American health care—and that APMs are critical to the transformation of our delivery system. Yet, recent proposals ignore the flawed Merit-Based Incentive Payment System (MIPS) that layers incentives on top of a flawed fee-for-service system that does nothing to control costs or improve quality. As we debate additional reductions to the APM bonus, MIPS retains a maximum bonus of 9%. This disparity sends the wrong message to providers and is why we believe any changes to APMs should be done in the broader context of MACRA reform.

A4H is committed to advancing alternative payment models that close gaps in our fragmented and frustrating fee-for-service system. While MACRA is helping accelerate the transition from fee-for-service to advanced APMs, we are in the early stages and substantial work remains. We must approach this work in a comprehensive way – not through piecemeal reductions to incentives for APM participation that leave fee-for-service incentives intact.

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). ###


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