Suppliers praise bill introduced to extend APM incentive payments for two more years

Suppliers praise bill introduced to extend APM incentive payments for two more years

On Wednesday, Dec. 14, two senators, a Republican and a Democrat, introduced a bill in the Senate that would extend incentive payments for providers participating in alternative payment models (APMs) for two more years, responding to calls from the patient care organization. leaders participating in CPAs, including in Accountable Care Organizations (ACOs) for an extension of these incentives beyond the Public Health Emergency (PHE), which is expected to end soon.

A press release on Tuesday announced the Sens’ legislative decision. John Barrasso (R-Wyo.) and Sheldon Whitehouse (D.-RI). It started like this: “Today, U.S. Sen. John Barrasso (R-Wyo.) and U.S. Sen. Sheldon Whitehouse (DR.I.) introduced the Value-Based Care Access Preservation Act . This bipartisan legislation ensures that health care providers through Medicare continue to commit to value-based models, or alternative payment models (APMs). This program reimburses providers for the quality of care, rather than the number of services they provide. Physicians who participate in MPAs overwhelmingly agree that value-based care provides high quality care.

The press release went on to note that “This bill will extend the 5% Advanced APM Incentive Payment for Suppliers for two additional years. The bill also ensures that qualification thresholds remain at achievable levels for practices that participate in Medicare’s advanced APMs. This incentive payment is scheduled to expire at the end of 2022 if Congress does not extend the program.

And he quoted the two senators. “As a physician, I know how essential it is for Medicare to meet the health care needs of America’s seniors. There is agreement on both sides of the aisle that alternative payment models (APMs) are a key solution to helping more seniors receive better care at lower cost,” said Senator Barrasso. “Our bipartisan legislation will ensure that this incentive program continues to help provide the highest quality care to seniors across the country.” “Rhode Island’s responsible care organizations have been national leaders in improving patient care and reducing costs. Medicare has recouped millions from their success,” said Senator Whitehouse. “We need to encourage more innovation in healthcare, not pull the rug out from under the people who make the system work better for everyone. There is strong bipartisan support for our proposal to allow these providers to continue to provide coordinated, high-quality care.

The bill was immediately welcomed by leaders of organizations involved in COAs and CPAs. “These critical Congressional-created incentives, which expire at the end of the year, have been instrumental in fueling the transition to value-based care that provides patients and our health care system with better outcomes and better quality care, Clif Gaus, Sc.D., president and CEO of the Washington, DC-based National Association of ACOs (NAACOS), in a statement contained in the press release.

And Jack Resneck Jr., MD, president of the American Medical Association (AMA), was quoted in the press release as saying, “With each passing year, it becomes more urgent to provide physicians with greater opportunities to participate in alternative payment models (APMs) where they can improve quality and value for patients while reducing burdens on physicians and practices.While it is also important to maintain a viable option of fee-for-service, the Merit-Based Incentive Payment System (MIPS) contributes to physician burnout by requiring physicians to spend approximately $12,800 and more than 200 hours of staff time annually on compliance with the place of patient care. A strong package of PADs is key to easing this burden. We commend Sens. Whitehouse and Barrasso for this sensible bill to extend PAD incentive payments for two years. M and enable physicians to gradually increase their degree of participation in value-based models of care,” he added.

Meanwhile, Susan Dentzer, president and CEO of APG, America’s Physician Groups, said in a statement that “America’s Physician Groups commends Senators Whitehouse and Barrasso for introducing bipartisan legislation to expand Medicare incentive payments. essential for clinicians participating in advanced alternative payment models.. About 300,000 physicians and other clinicians engaged in these models are using the five percent premiums on Medicare’s physician fee schedule to build the systems needed to better coordinate care patients. Incentives have been particularly helpful in attracting more specialists to value-based payment arrangements. It is important not to interrupt this process of transition, and the extension of premiums for another two years, as this legislation, will help maintain momentum to provide more centered care patient-based and value-based for those enrolled in traditional Medicare. ”

And Jerry Penso, MD, president and CEO of AMGA, the American Medical Group Association, endorsed the legislation, saying, “The Advanced APM program is critical to Medicare’s continued transition to value. This bill ensures that Medicare provides the support providers need to begin and continue the journey to value. The passage of this bill sends a clear signal that value is here to stay in the Medicare program.

Ashley Ridlon, vice president of health policy at New York-based Evolent Health, whose Evolent Care Partners division manages 1,500 providers in nine states involved in their ACO Medicare Shared Savings Program (MSSP), says the issues addressed in the new bill are of enormous interest to suppliers, in terms of their continued participation in NPAs. “We see physicians, especially primary care physicians, really struggling,” says Ridlon. “There are 4.5% cuts coming next year. I worked on Capitol Hill during the days of the SGR cuts, and all of a sudden it’s a feeling like that. The big picture here, she says, is “the sustainability of physician payment. We would say that this 5% prepayment should be part of the doctors’ payment. We believe that if Congress addresses payment for physicians, value must be part of the equation. And the bonus was effective; we have seen ACOs grow significantly. But to date, only 20% of doctors are qualified for the bonus. It therefore failed to meet expectations. »

Ultimately, Ridlon says, “We’d like to see at least two more years of having this help incentivizing providers to participate. We have already recruited providers for 2023. And in 2023, we could say to providers, join this model and you can benefit from the premium in 2024.”

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