Press Releases

Washington, D.C. - Today, Representatives Brad Wenstrup (R-OH), Darin LaHood (R-IL), Larry Buschon (R-IN), Suzan DelBene (D-WA), Earl Blumenauer (D-OR), and Kim Schrier (D-WA) 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) to incentivize participation in Accountable Care Organizations (ACO). 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.

"As a physician, I know how important it is that we are valuing positive patient outcomes over the sheer volume of services provided. This legislation will help improve health care access and quality for seniors, particularly in rural communities, by encouraging more providers to participate in value-based health programs and coordinating care between hospitals, physicians, and health care providers,” said Rep. Wenstrup, D.P.M.

"The Value in Health Care Act is a commonsense proposal that includes substantive reforms to encourage and support greater participation by healthcare providers in ACO’s, particularly in our rural communities in Illinois,” said Rep. LaHood. “By incentivizing the use of these value-based health models that support coordinated care between doctors, hospitals, and other healthcare providers, this legislation will improve healthcare access and the quality of care for seniors and patients across my district.”

"Having been a practicing heart surgeon for over 15 years, I believe it’s critical we continue working to move our health care system away from simply reimbursing health care providers based on volume – like a commodity – to reimbursing providers for providing quality care that achieves positive outcomes for patients,” said Rep. Bucshon, M.D. “I believe this legislation will help us ensure that more health care providers – especially independent practice and rural providers – can easily participate in Medicare’s value-based and coordinated care programs, which will improve access to quality care for seniors.”

"Physicians and hospitals participating in Alternative Payment Models are leading the changes our health care system needs to focus on value instead of volume. 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 Rep. 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.”

“The Value in Health Care Act is an effort to make our health care system more efficient and create an environment where providers are rewarded for transitioning to ways of providing healthcare that don’t compensate based on numbers of visits or procedures, but based on patient outcomes," said Rep. Schrier, M.D. "This bill incentivizes coordinated and value-based care for our seniors by expanding access for Medicare patients. It has proven to save billions of dollars for taxpayers while improving care, and is exactly the type of pragmatic, bipartisan legislation that we can move through this Congress.”

"For too long, our health care system has prioritized volume over value,” said Rep. Blumenauer. “This is unsustainable for providers, patients, and the federal government. It is time we move toward a future that lowers costs while maintaining high-quality care for patients.”

Alternative Payment Models (APM) have played a key role in providing high-quality care for Medicare beneficiaries while producing billions of dollars in savings for taxpayers in the past decade. However, rules implemented to the Accountable Care Organizations (ACO) programs have limited the number of providers participating. The Value in Health Care Act helps maintain and further strengthen the movement towards value where financial performance is linked to the quality of patient care rather than the number of services delivered.

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 percent 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.

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