If incentives are allowed to expire at the end of the year, it could negatively affect participation rates
More than 800 health care associations, accountable care organizations, medical practices, and health systems wrote a letter to congressional leaders to extend incentive payments intended to encourage participation in risk-bearing alternative payment models (APMs). The incentives will expire without congressional action.
The incentives were created by congress in 2015 and include a 5 percent payment to help providers move to new payment models, including ACOs. While 300,000 clinicians are expected to receive the incentive this year, this is far short of what was intended. The letter calls for more time to allow more providers to move to APMs, which can improve quality and lower overall cost of care.
“Ending these important incentive payments would discourage future participation in models that have seen growing uptake in recent years,” the letter states. “The incentive payments not only encourage physicians and additional health care practitioners 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, National Association of ACOs, Primary Care Collaborative, and 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. These can all boost patient outcomes, care quality, and satisfaction.
“ACOs, the predominant type of Advanced APM, have used these incentives to fund wellness programs, pay for patient transportation and meals programs, reduce cost sharing for beneficiaries, and hire care coordinators,” the letter states. “These are services that are not typically reimbursed through Medicare but improve patient health outcomes and wellbeing.”