The Value in Health Care Act introduced in Congress has received the support of fourteen major groups in health care ranging from the American Medical Association to America’s Health Insurance Plans to the major hospital organizations in the country. The aim of the legislation is to attract more participation in the Accountable Care Organizations (ACOs) and alternate payment models (APMs) by increasing the dollars in the shared savings models for ACOs and addressing the risk adjustment issues that have had a negative impact on community providers.
Proponents of the APMs and the sponsors of the bill have included requirements for the Government Accountability Office to study health outcomes for Medicare beneficiaries in Fee for Service compared to those in ACOs. Additional funding, additional research, and new risk adjustment efforts signal that the shift to value-based care remains a priority in how to evaluate and pay for health care. While the merits of the bill get debated in Congress, the Biden Administration is considering requiring the ACOs submit race and ethnicity data as requirements for participation.