Lawmakers propose ACO alternative

Proposed legislation would target how Medicare treats patients with chronic illnesses, which supporters of the bill say would create a more effective and efficient coordinated care process, according to Medscape.

Under the Better Care, Lower Cost Act--a bipartisan effort pitched earlier this month by Sens. Ron Wyden (D-Ore.) and Johnny Isakson (R-Ga.) and Reps. Erik Paulsen (R-Minn.) and Peter Welch (D-Vt.)--healthcare providers would voluntarily form certified teams called Better Care Programs (BCPs). Unlike accountable care organizations, BCPs would be free to target Medicare patients with chronic illnesses, Medscape writes.

BCPs would receive capitated, risk-adjusted payments for Medicare beneficiaries with multiple chronic illnesses; if the team reduced the need for inpatient care and came in under its capitation budget, it would share in the savings. However, BCPs would have to make up the government's loss if they went over budget.

As part of the legislation, the U.S. Department of Health & Human Services would help medical schools rewrite curriculum to train students in team-based care, chronic care management, palliative medicine and other areas--with non-compliant teaching hospitals risking cuts to graduate medical education payments, according to the article.

The bill would also ensure providers could practice "at the top" of their licenses, which could mean expanded scope of practice for nurse practitioners and other nonphysician clinicians, the article states.

"Medicare is now dominated by cancer, diabetes, heart disease, and other chronic conditions," Wyden said, according to the article. "Medicare reform must be built around offering better quality, more affordable care for these seniors. Fortunately, there are pioneering practices and plans that are paving the way."

To learn more:
- here's the Medscape article