Us Congress House Bill HB5013

Us Congress 2023-2024 Regular Session

• Introduced: 7/27/23
• Refer: 7/27/23
• Refer: 7/28/23

Caption

Value in Health Care Act of 2023

Impact

If enacted, HB5013 will impact existing Medicare regulations, particularly by eliminating specific distinctions between different types of ACOs, thus promoting broader participation. A major component is the introduction of a voluntary full-risk option under the Medicare Shared Savings Program, which would allow ACOs to retain 100% of shared savings while taking on significant risk for any shared losses. This shift is designed to incentivize healthcare providers to engage more actively in cost-saving initiatives and improve the overall efficiency of care delivery.

Summary

House Bill 5013, titled the ‘Value in Health Care Act of 2023,’ aims to revise regulations related to the Medicare shared savings program and other alternative payment arrangements. The bill directs the Secretary of Health and Human Services to remove barriers to participation in these programs, specifically for accountable care organizations (ACOs). These changes would streamline the participation process for both low and high revenue ACOs by standardizing requirements and potentially easing financial responsibilities associated with shared losses.

Contention

Despite its intended goals of encouraging participation and promoting efficiency, there are concerns regarding the potential implications of reducing financial burdens on ACOs. Critics may argue that removing stringent requirements could lead to a lack of accountability for organizations that might not prioritize quality care. Moreover, the potential for a significant shift in resource allocation could disproportionately affect rural and medically underserved areas, where adequately supporting healthcare infrastructure and providers is already challenging. The effectiveness of the proposed financial methodologies in achieving fair and equitable outcomes will likely be a point of contention as the bill moves forward.