Improve the Long-Term Sustainability of Value-Based Care

ACOS ARE LOWERING COSTS AND KEEPING PATIENTS HEALTHIER

In the last decade accountable care organizations helped lower Medicare spending by more than $34 billion.
ACOs are great stewards of the Medicare program, regularly identifying instances of suspected fraud, waste, and abuse—flagging more than $3 billion in DME catheter fraud and increased spending on skin substitutes.

13 million seniors on Medicare rely on clinicians in ACOs to help keep them healthy.
The growth of value-based care has resulted in better, more cost-effective care of patients by focusing on keeping patients healthy and providing the right care at the right time and place

Create a predictable pathway for participants by making REACH/ Direct Contracting a permanent program.
Grow the Medicare Shared Savings Program by removing the Accountable Care Perspective Trend (ACPT), eliminating arbitrary designations (such as high/low revenue) that discourage participation by specialists, and establishing a voluntary, full-risk track.
Require CMS to develop transparent guardrails for setting financial benchmarks that fairly account for regional spending variations and prevent arbitrary winners and losers.

Reduce burdensome and costly quality requirements by supporting the Health Care Efficiency Through Flexibility Act (H.R. 483), which requires CMS to pilot-test reporting approaches and delaying mandatory electronic clinical quality measure (eCQM) reporting until 2030.
Bring tested innovations (e.g., capitation, tailored benefit cost-sharing) into all total cost of care models.
Eliminate other burdensome low-value requirements, such as stringent beneficiary notifications that increase burdens and costs on providers.

ACOs need support from CMS to continue fighting fraud and wasteful spending in Medicare by: (1) holding ACOs harmless for fraudulent spending, (2) improving reporting, and (3) building a better feedback loop to ACOs.