Value in Health Care Act of 2023 Introduced to Congress to Reinforce Value-Based Care

Seventeen of the nation’s leading stakeholders in healthcare are backing a bipartisan House bill recently introduced to Congress that would reinforce Medicare’s move to value-based care.

The support of the Value in Health Care Act of 2023, a bipartisan legislation that would make several important reforms to ensure alternative payment models (APMs) continue to produce high quality care for the Medicare program and its beneficiaries, was introduced in a letter signed by the stakeholders.

This act follows the Value in Health Care Act of 2021, which was reintroduced the same day by Reps. Darin LaHood (R-Ill.), Suzan DelBene (D-Wash.), Brad Wenstrup, D.P.M. (R-Ohio), Earl Blumenauer (D-Ore.), Larry Bucshon, M.D. (R-Ind.), and Kim Schrier, M.D. (D-Wash.).

The Value Act of 2021 was created to make a series of changes to certain methodologies and components used in the Medicare Shared Savings Program, according to Congress. The program was made to enable accountable care organizations (ACOs) to receive payments for savings stemming from care coordination and management.

The Value in Health Care Act of 2023 would make several improvements to CMS’s value-based care programs, per one of its 17 supporters, the National Association of ACOs (NAACOS).

In relation to the improvement of APMs — though they have generated billions of dollars in savings and have maintained quality of care — their growth produced an overflow on care delivery, potentially slowing the overall rate of growth of healthcare spending, as stated in the letter.

“A key aim of the bipartisan Medicare Access and CHIP Reauthorization Act (MACRA) was to speed the transition to patient-centered, value-based care by encouraging physicians and other clinicians to transition into APMs,” the letter states. “While MACRA was a step in the right direction, the transition has been slower than anticipated and more needs to be done to drive long-term system transformations. The Value in Health Care Act helps maintain and further strengthen the movement towards high-quality care where financial performance is linked to the quality of patient care rather than the number of services delivered.”

In a NAACOS release, overall, the Value Act of 2023 would:

• Provide a two-year extension of the 5% advanced alternative payment model (APMs) incentives created by the 2015 Medicare Access and CHIP Reauthorization Act (MACRA) that are scheduled to expire at the end of the year.
• Give CMS the authority to adjust the thresholds to secure those incentive payments, allowing more opportunities to bring rural, underserved, primary care or specialty practices into APMs.
• Eliminate the artificial revenue-based distinction that disadvantages rural and safety net providers critical to improving access to care and improving health equity.
• Create a more fair, more transparent process to set financial spending targets so that ACOs are not penalized for their own success.
• Establish a voluntary track for ACOs to take on higher levels of risk.
• Provide technical assistance for clinicians new to APMs.
• Study ways to increase parity between APMs in traditional Medicare and Medicare Advantage so both programs are attractive and sustainable options.

NAACOS stated in the release that ACOs have generated over $17 billion in gross savings for Medicare over the last decade and improved the quality of care for millions of patients. More than 13 million beneficiaries are cared for by an ACO today.

In support of ACOs and all improvements the Value Act of 2023 would generate, the remaining stakeholders behind the Act include Accountable for Health, American Academy of Family Physicians, American Academy of Orthopaedic Surgeons, American College of Physicians, American Hospital Association, American Medical Association, America’s Essential Hospitals, AMGA, America's Physician Groups, Association of American Medical Colleges, Federation of American Hospitals, Healthcare Leadership Council, Health Care Transformation Task Force, Medical Group Management Association, National Association of ACOs, National Rural Health Association, and Premier, Inc.