More than 800 healthcare organizations push to maintain value-based payment incentives

If incentives are allowed to expire at the end of the year, this could negatively affect take-up rates

More than 800 health care associations, accountable care organizations, medical practices and health systems have written a letter to congressional leaders to expand incentive payments intended to encourage participation in risky alternative payment models (APMs). The incentives will expire without congressional action.

The incentives were created by Congress in 2015 and include a 5% payment to help providers transition to new payment models, including ACOs. While 300,000 clinicians are expected to receive the incentive this year, that’s far from what was expected. The letter calls for more time to allow more providers to switch to APMs, which can improve quality and reduce the overall cost of care.

“Terminating these large incentive payments would discourage future participation in models that have seen increasing adoption in recent years,” the letter states. “Incentive payments not only encourage additional physicians and healthcare professionals to enter models, but also provide additional resources that can be used to expand services beyond traditional fee-for-service.”

The letter was signed by 805 organizations, including just under 600 medical practices, more than 200 ACOs and health systems, and 17 provider associations and coalitions. Signatories include the American Academy of Family Physicians, American College of Physicians, American Medical Association, American Medical Group Association, America’s Physician Groups, Association of American Medical Colleges, Medical Group Management Association, the National Association of ACOs, the Primary Care Collaborative and the Value Based Care Coalition.

The letter warns that if the incentives expire, some patient services would be lost. The incentives help providers invest in digital health tools, care coordinators, data analytics, transitional care services and patient engagement. All of this can improve patient outcomes, quality of care and satisfaction.

“ACOs, the predominant type of advanced APM, have used these incentives to fund wellness programs, pay for patient transportation and meal programs, reduce cost sharing for beneficiaries, and hire care coordinators. “, indicates the letter. “These are services that aren’t typically reimbursed by Medicare, but that improve patient health outcomes and well-being.”

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