Press Releases

Today, Representatives Suzan DelBene (WA-01), Darin LaHood (IL-16), Kim Schrier, MD (WA-08), Brad Wenstrup (OH-02), Earl Blumenauer (OR-03), and Larry Bucshon, MD (IN-08) introduced a bipartisan bill that would make commonsense changes to Medicare’s Alternative Payment Models (APMs) program to incentivize greater participation in value-based health programs. The Value in Health Care Act would help increase participation in Accountable Care Organizations (ACOs), which are designed to improve the quality of care and health outcomes for seniors while lowering costs.

“Physicians and hospitals participating in Alternative Payment Models are leading the changes our health care system needs to focus on value instead of volume. Providers should be paid based on the quality of the care they deliver, not the quantity of services. The Value in Health Care Act would encourage more providers to join these models and accelerate this change, leading to improved quality of care and health outcomes for seniors,” said DelBene. “Shifting to value will also save everyday people and our health system money in the long term. We must continue to provide the incentives that expand access to coordinated and comprehensive care.”

Alternative Payment Models are playing a key role in providing high-quality care for Medicare beneficiaries while saving billions in taxpayer dollars over the past decade. However, 2019 changes to the Accountable Care Organizations program reduced participation. The Value in Health Care Act would help accelerate the movement towards value where financial performance is linked to the quality of patient care rather than the number of services delivered.

“More than a decade of experience shows us that value-based care is improving patient outcomes, delivering high-quality care at lower costs, while maintaining important patient protections. Accountable care organizations alone have saved Medicare more than $17 billion while improving quality. The Value in Health Care Act would maintain incentives to bring more providers into value-based care models and expand access for beneficiaries. This important piece of legislation should be part of Congress’s conversation to update physician payment. We thank Reps. LaHood, DelBene, Wenstrup, Blumenauer, and Schrier for their leadership on this issue,” said Clif Gaus, President and CEO, National Association of ACOs.

“The reforms in this legislation provide much-needed support for hospitals who have invested in value-based arrangements. The legislation also incentivizes others to make this challenging but important transition. The Washington State Hospital Association appreciates Congresswoman DelBene’s leadership in supporting hospitals as they continue to move to value-based health care,” said Cassie Sauer, CEO, Washington State Hospital Association.

“Value-based care has resulted in better outcomes for patients at lower costs and promotes the right care being delivered at the right location,” said Dr. Nariman Heshmati, an Everett-area OBGYN and President-Elect, Washington State Medical Association. “As a physician helping organizations transition to value-based care, the Value in Health Care Act of 2023 will facilitate the type of innovation and efficiency we need in our health care system and improve the quality of care that millions of Medicare patients receive.”

“The Value Act establishes important priorities in advancing health care delivery that drives health outcomes over the volume of services provided. MACRA established incentives to drive the transformation from fee-for-service to accountable care because a broad, bipartisan group of lawmakers knew America’s health care delivery system must improve to meet people’s needs. The pandemic demonstrated we need innovation in health care more than ever before, yet progress is threatened by incentives that will expire at the end of this year. The Value Act ensures this investment in people’s health continues for two more years. Accountable for Health and its members look forward to working with Representatives LaHood and DelBene to advance this bill and continue transforming American health care away from fee-for-service toward high quality, accountable care,” said Mara McDermott, CEO, Accountable for Health.

The Value in Health Care Act would make the following changes to the APM and ACO parameters:

• Encourages participation in the Medicare ACO program by increasing the percentage of shared savings beginner participants receive. Program changes under previous administrations decreased shared savings, making the program less attractive.
• Modifies risk adjustment to be more realistic and better reflect factors participants encounter like health and other risk variables in their communities.
• Removes barriers to ACO participation by eliminating arbitrary program distinctions so all participants are participating on a level playing field.
• Supports fair and accurate benchmarks by modifying performance metrics so participants aren’t competing against their own successes in providing better care.
• Provides greater technical support to ACO participants to cover the significant startup costs associated with program participation.
• Incentivizes participation in Advanced APMs by extending the annual lump sum participation bonus for an additional two years.
• Corrects arbitrary thresholds for Advanced APM qualification to better reflect the existing progress of the value-based movement and to encourage bringing more patients into this model of care.