A new bipartisan Senate bill aims to extend for two years a 5% bonus to doctors who participate in alternative payment models, with lawmakers having little time to get it through Congress before the holidays.
Sens. Sheldon Whitehouse, D-Rhode Island, and John Barrasso, R-Wyoming, introduced on Wednesday the Preserving Access to Value Based Care Act to save the bonus that goes away in 2023. Provider advocacy groups lauded the bill as a critical tool that will help get more doctors into value-based care.
“We need to encourage more health care innovation—not pull the rug out from under the people who are making the system work better for everyone,” said Whitehouse in a statement. “There is strong bipartisan support for our proposal to allow these providers to continue delivering high-quality coordinated care.”
The 5% bonus went to doctors that sign up to participate in an advanced alternative payment model.
A recent estimate from the Alliance for Value-Based Patient Care, a collection of patient groups, finds approximately 300,000 physicians rely on the incentive and one-third could drop out of the models if it goes away.
“Congress will be playing with fire by not extending these critical incentives, which are important to providing patients and our health system with better outcomes and higher quality care,” Clif Gaus, president and CEO of the National Association of ACOs, in a statement.
Some providers have said the bonus has been a key selling point for physicians to join an accountable care organization and defray some of the infrastructure costs like staffing and care management.
“It really is meeting a lot of the need in terms of making sure value-based care is successful,” said Ashley Ridlon, vice president of health policy for managed care services company Evolent Health, in an interview with Fierce Healthcare. “This incentive is important to encourage providers to escalate up into … advance tracks.”
It remains unclear whether the bill will be able to make it before Congress leaves for the year. It is competing with a slew of other priorities for Congress, including in the healthcare arena as physicians are hoping to get rid of a 4.5% cut to Medicare payments as part of the Physician Fee Schedule.
Lawmakers are currently crafting a must-pass omnibus spending bill in which the legislation could be included. Negotiators in the House and Senate have released a framework on the omnibus but have not announced top-line numbers nor what other legislative riders could be included.