Provider Associations Laud Bipartisan, ACO-Focused Legislation

Sept. 22, 2016
Four major healthcare professional associations on Thursday publicly expressed support for legislation aimed at modifying the Medicare Shared Savings Program for ACOs in order to ease providers’ concerns

Bipartisan legislation introduced in the U.S. House of Representatives on Sep. 21 is receiving support from several healthcare professional associations.

On Wednesday, representatives Diane Black (R-TN) and Peter Welch (D-VT) introduced H.R. 6101, the ACO Improvement Act of 2016, which would make significant changes to the Medicare Shared Savings Program (MSSP) for accountable care organizations. That legislation represents the reintroduction of a similar bill first introduced in September 2014.

Specifically, the legislation encourages care coordination by allowing Track 1 ACOs the option of prospective attribution of members/beneficiaries, reduces regulatory burdens for these ACOs by waiving the telehealth site-of-service requirements, and encourages patient engagement by allowing these ACOs the ability to waive cost-sharing for primary care services, and to take on the role of offering attributed patients incentives and benefits. The legislation also would extend regulatory relief to Track 2 ACOs by waiving the Medicare three-day inpatient qualifying stay for the skilled nursing facility benefit and home health homebound requirements. And it would allow for remote monitoring in the home, in connection with home healthcare services.

In a statement made public through a press release, the Alexandria, Va.-based AMGA stated that “We thank Reps. Diane Black and Peter Welch for their leadership on this legislation aimed at improving the ACO program for patients and providers,” said AMGA President and CEO Donald W. Fisher, Ph.D., CAE. More than 100 AMGA members joined MSSP and they have improved care and reduced costs; however, they have struggled with outdated requirements. The suggested policy changes are a positive step that will improve the long term viability of the MSSP program. We look forward to continuing to work with the sponsors, Congress, and the Administration on improving the ACO program.”

What’s more, a coalition of four associations—the AMGA, the Philadelphia-based American College of Physicians, the Washington, D.C.-based National Association of ACOs (NAACOS), and the Charlotte-based Premier Healthcare Alliance, on Thursday, Sep. 22, sent a letter to Reps. Black and Welch, expressing their support.

The letter states that “The undersigned applaud the introduction of H.R. 6101, ‘The ACO Improvement Act of 2016.’ The signatories to this letter represent the largest and most preeminent healthcare organizations in the country whose members include physicians, hospitals, medical group practices and nearly all existing Medicare Shared Savings Program (MSSP) ACOs. This legislation provides sensible modifications to the Medicare Shared Savings Program (MSSP) program, including operational changes that will benefit Medicare beneficiaries by promoting coordinated health care and allow Medicare ACOs to succeed and remain a viable business model.”

The letter goes on to state that “The ACOs that we represent are leading the movement toward value-based payment and, based on their experience in caring for Medicare beneficiaries in communities around the country, have been advocating for the needed and timely changes in the legislation. Passage of H.R. 6101 would strengthen ACOs in the Medicare Shared Savings Program and give physicians and clinicians more tools to provide better-coordinated care, resulting in improved quality standards and generating savings for the Medicare Trust Fund.”

Healthcare Informatics will continue to update readers as new developments occur.

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