- Representatives Diane Black (R-TN) and Peter Welch (D-VT) have proposed new legislation to boost accountable care organizations and increase the focus on paying for performance and away from fee for service.
- The ACO Improvement Act takes a multi-pronged approach to supporting ACOs. The bill creates incentives to engage patients in their care, emphasizes outcomes over services and permits telehealth and remote patients monitoring. It also proposes to increase collaboration among doctors and patients by providing things like lowered out-of-pocket expenses for primary care visits. Finally, it provides more detailed benchmarks and standards of care.
- Black is a member of the House Ways and Means Committee and is a registered nurse. Welch authored a nationwide Medicare ACO program in the Affordable Care Act and is a member of the House Energy and Commerce Committee. These two committees oversee the healthcare legislation in the House.
"If we are going to reduce health care costs and increase quality, the incentives built into the provider payment system need to be changed. In short, we need to reward value, not volume," said Welch in a statement on Black's website. "Paying health care providers based on improvements in patient health rather than the number of procedures they perform is the way of the future."
Although the bill's approach includes increased usage of technology like telehealth services, the focus is clearly on moving the needle toward more value-based care. Legislation like this may be a requirement because recent reports have found that most payment models have not yet changed. A study released last week found that more than three-quarters of nonprofit hospitals said that value-based reimbursement accounts for less than 10% of total revenue.