Bill to Improve Medicare ACO Program Includes Telehealth Provisions

A bi-partisan bill introduced in the House of Representatives last week aims to improve the Medicare Shared Savings Program (MSSP) by modifying the rules for Accountable Care Organizations (ACOs). It includes telehealth provisions sought by providers, who were quick to praise the proposed legislation.

The bill increases incentives for ACOs to focus on quality of care. Among other things, the bill seeks to improve care coordination through increased access to telehealth and remote patient monitoring.

The ACO Improvement Act of 2016, introduced by U.S. Representatives Diane Black (R-TN) and Peter Welch (D-VT), would waive the program’s telehealth site-of-service requirements and expand the use of remote patient monitoring and home-based video conferencing in connection with home health services.

In addition, the bill would waive the three-day prior hospitalization requirement for coverage of skilled-nursing facility services and end the homebound requirement for coverage of home health services. It also encourages patient engagement by allowing ACOs to waive cost sharing for primary care services.

Provider groups are singing the bill’s praises. CAPG President and CEO Donald Crane said, “We applaud Congressional authors Black and Welch for coming together in a bipartisan fashion to ensure a solid foundation is laid for physician organizations to transition from fragmented fee-for-service to lower-cost, coordinated care that puts patients first.”

Healthcare Informatics reports that a coalition of four provider associations – the American Medical Group Association (AMGA), American College of Physicians, the National Association of ACOs (NAACOS), and Premiere Healthcare Alliance – sent a letter to Reps. Black and Welsh expressing support.

The letter states, “This legislation provides sensible modifications to the Medicare Shared Savings Program (MSSP) program, including operational changes that will benefit Medicare beneficiaries by promoting coordinated health care and allow Medicare ACOs to succeed and remain a viable business model.”

“The ACOs that we represent are leading the movement toward value-based payment and, based on their experience in caring for Medicare beneficiaries in communities around the country, have been advocating for the needed and timely changes in the legislation. Passage of H.R. 6101 would strengthen ACOs in the Medicare Shared Savings Program and give physicians and clinicians more tools to provide better-coordinated care, resulting in improved quality standards and generating savings for the Medicare Trust Fund.”

Click here to read the text of H.R. 6101.

Click here to read the Healthcare Informatics article on provider association support for the proposed legislation.

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