Calling on Congress: Lawmakers urged to support a transition to value-based care
Value-based payment reforms have generated more than $17 billion in gross savings for Medicare over the past decade, wrote 12 health care organizations in an open letter to the 118th Congress.
A dozen leading health care organizations in the United States are asking lawmakers to keep momentum moving toward value-based care in the new Congress.
In a letter sent this week, the groups — including the American Medical Association, the National Association of ACOs, Health Care Transformation Task Force and the National Rural Health Association — outline legislative priorities they say will improve adoption of value-based care models. Such models, they add, have been proven to provide better patient care by encouraging physicians and other clinicians to coordinate care across settings and be more accountable to patient outcomes.
Congress in recent years has sought to speed the transition to value-based care, which ties payments for care delivery to the quality of care provided, by encouraging physicians and other clinicians to transition to alternative payment models (APMs), primarily through the bipartisan Medicare Access and CHIP Reauthorization Act (MACRA). While roughly 30% of Medicare clinicians are participating in risk-based payment models, the rate of uptake remains below original projections, according to the letter, which was addressed to chairs and ranking members of the Senate Committee on Finance, the House Committee on Energy and Commerce, and the House Committee on Ways and Means.
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“While MACRA was a step in the right direction, more needs to be done to drive long-term system transformations,” the letter states. ”Stabilizing Medicare’s payment system and ensuring payment adequacy will also help physicians invest in the infrastructure and staffing necessary to transition into value-based models. We encourage your committees to hold hearings and engage with stakeholders to consider long-term approaches for advancing value.”
Specifically, the letter asks lawmakers to do the following:
- Extend value-based care incentives by extending the original 5% advanced APM incentive payments.
- Ensure participants join and remain in value-based care models by removing barriers to APM participation.
- Provide a more predictable pathway for more clinicians to engage in APMs by working with the CMS Innovation Center to ensure promising models have a better pathway to be implemented and become permanent.
- Establish parity between APMs and Medicare Advantage (MA) by seeking greater alignment between APMs and the MA program to ensure that both models can achieve success.
According to the letter’s co-signers, value-based payment reforms have generated “more than $17 billion in gross savings” for Medicare over the past decade and improved the quality of care for millions of patients. More than 13 million beneficiaries are cared for by an Accountable Care Organization today, and nearly 573,000 physicians and other non-physicians participate in the Medicare Shared Savings Program.