Bipartisan Bill Calls for Extended Value-Based Payment Incentives

US Senators John Barrasso (R-WY) and Sheldon Whitehouse (D-RI) have introduced a bipartisan bill that would extend value-based payment incentives for healthcare providers participating in Medicare’s alternative payment models (APMs).

The Preserving Access to Value-Based Care Act will extend the 5 percent advanced APM incentive payment for an additional two years. In addition, the bill ensures that qualification thresholds remain attainable for providers participating in advanced APMs.

Without action, the 5 percent incentive payment will expire at the end of the year. Around 300,000 clinicians receive the incentive on their Medicare payments, mainly through participating in risk-bearing accountable care organizations (ACOs). If Congress allows the incentives to expire, it could discourage future participation in value-based payment models.

“Congress will be playing with fire by not extending these critical incentives, which are important to providing patients and our health system with better outcomes and higher quality care,” Clif Gaus, ScD, president and chief executive officer (CEO) of the National Association of ACOs (NAACOS), said in a press release.

“We realize that there are several competing priorities for lawmakers but hope they recognize the critical role value-based care providers play in improving our health system. We thank Sen. Barrasso and Sen. Whitehouse for their leadership.” 

ACOs have saved Medicare over $17 billion in gross savings and $6.5 billion in net savings since 2012. Additionally, ACOs provide quality care for nearly 20 percent of all Medicare beneficiaries and almost a third of traditional Medicare beneficiaries.

In addition to NAACOS, several industry groups applauded the bill’s introduction, citing how the advanced APM incentive payment has helped providers improve patient care quality.

“The incentives have been particularly useful for drawing more specialists into value-based payment arrangements,” Susan Dentzer, president and CEO of America’s Physician Groups (APG), expressed in a statement.

“It is important not to interrupt this transition process, and extending the bonuses for another two years, as this legislation would do, will help maintain the momentum for providing more patient-centered, value-based care for those enrolled in the traditional Medicare program.”

The American Medical Group Association (AMGA) echoed these thoughts as well.

“The Advanced APM program is critical in Medicare’s continued transition to value,” AMGA President and CEO Jerry Penso, MD, MBA, said in a statement. “This bill ensures that Medicare offers the support providers need to start and continue the journey to value. Passage of this bill sends a clear signal that value is here to stay in the Medicare program.”

Extending the value-based incentive payments has broad support from legislators on both sides of the aisle. In November, more than 40 House lawmakers sent a bipartisan letter to congressional leaders urging them to prolong the incentives.

In addition, 800 ACOs and healthcare associations, including NAACOS and the American Medical Association, requested an extension from Congress in September.