Reps. Diane Black, R-Tenn., and Peter Welch, D-Vt., Wednesday introduced the ACO Improvement Act of 2016 to help fine tune regulations, increase beneficiary engagement and improve health outcomes for CMS' Medicare Shared Savings Program accountable care organizations.
Here are six things to know about the bipartisan bill.
1. It aims to help ACOs strengthen patient-physician relationships. The bill proposes allowing the organizations to prospectively assign beneficiaries to ACOs and allowing beneficiaries to choose their own physician within their assigned ACO.
2. The bill also aims to enhance patient engagement by adding built-in incentives. Specifically, the bill would reduce or eliminate cost sharing for primary care services, and it calls for the development of additional incentives to help patients get involved in their own wellness.
3. It calls for regulatory relief for ACOs with two-sided risk (Tracks 2 and 3 of MSSP). This relief includes waiving the requirement that a patient be hospitalized for three days for Medicare to cover skilled nursing facility services, as well as waiving the homebound requirement for coverage of home health services.
4. The bill calls for additional care coordination through telehealth.It aims to reduce regulatory burdens by waiving site-of-service requirements for telehealth services.
5. To help accelerate the advancement to value-based care, the bill also calls for CMS to allow ACOs to assume greater risk and move to a more advanced track each calendar year.
6. The bill has garnered support from providers. The American Medical Group Association lauded the effort. "We thank Reps. Diane Black and Peter Welch for their leadership on this legislation aimed at improving the ACO program for patients and providers," AMGA President and CEO Donald Fisher, PhD, said in a statement. "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than 100 AMGA members joined MSSP and they have improved care and reduced costs; however, they have struggled with outdated requirements.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."
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