DelBene, Welch, LaHood, Wenstrup Introduce Bipartisan Legislation to Incentivize Value-Based Health Care
Today, Representatives Suzan DelBene (WA-01), Peter Welch (VT-At-large), Darin LaHood (IL-18), and Brad Wenstrup (OH-02) reintroduced the Value in Health Care Act, a bipartisan bill that will make commonsense changes to the program parameters of Medicare’s Alternative Payment Models (APMs). The changes will increase participation in these value-based health programs that are designed to improve the quality of care and health outcomes for seniors while lowering costs.
In 2017, a U.S. Health and Human Services Inspector General report found that 98 percent of Accountable Care Organizations (ACO), after participating for three years, met or exceeded quality measures and outperformed regular fee-for-service providers on 81 percent of quality measures. However, in 2019, after changes were implemented to the ACO program, fewer providers participated for the first time since its inception in 2012.
In 2019, ACOs participating in Medicare’s ACO program achieved their highest annual savings since the program’s start in 2012, producing $1.4 billion in net savings. Since 2012, ACOs have saved Medicare a net $2.5 billion.
The Value in Health Care Act would make the following changes to the APM and ACO parameters:
“Physicians and hospitals participating in APMs are driving the change in health care we so desperately need. The Value in Health Care Act makes sensible modifications to the existing APM parameters and encourages more providers to participate. This ultimately helps seniors by improving the quality of care and outcomes,” said DelBene. “ACOs in Washington were critical to providing coordinated care for seniors during the pandemic and we should continue to incentivize these models in our communities.”
“Accountable Care Organizations are vital to our work to drive down health costs in this country — which are far too high. By using a more collaborative approach to health care, we can improve both quality and efficiency in patient access and care. We need to encourage value, not volume of services,” said Welch. “ACOs deliver better care for a better price, and we should continue working to make sure that they succeed.”
“The Value in Health Care Act is a commonsense proposal that includes substantive reforms to encourage and support greater participation by health care providers in ACOs, particularly in our rural communities in central and west-central Illinois,” said LaHood. “By incentivizing the use of these value-based health models that support coordinated care between doctors, hospitals, and other health care providers, this legislation will improve health care access and the quality of care for seniors and patients across my district, which is critical as we recover from COVID-19.”
“It’s important that we give health care providers additional flexibility if we’re going to successfully transition our health care system into one that prioritizes the value of positive patient outcomes over just the sheer volume of services provided,” said Wenstrup. “Our bipartisan legislation helps accomplish that and puts our health care system on a better track to keep patients healthier for lower costs.”
Under MACRA, providers participating in quality improvement programs can choose between an APM or the Merit-Based Incentive Payment System (MIPS). Both programs incentivize providers to improve quality and contain costs.