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.
Educational Opportunity and Success Act of 2023 This bill reauthorizes through FY2029 and otherwise revises TRIO programs. (These outreach and student-services programs identify and provide services to students from disadvantaged backgrounds.) Among other revisions to the programs, the bill prohibits the Department of Education (ED) from rejecting TRIO grant applications based on certain errors; requires ED to provide additional technical assistance to interested grant applicants; revises the outcome criteria for measuring the quality and effectiveness of the programs, including those programs specifically designed for veterans; allows program administrators to use a student's most recent Free Application for Federal Student Aid to determine TRIO program eligibility; and increases the maximum stipend for students participating in the Upward Bound Program or the Ronald E. McNair Postbaccalaureate Achievement Program.
Education Freedom Scholarships and Opportunity Act This bill allows individual and corporate taxpayers a tax credit for cash contributions to certain scholarship-granting and workforce training organizations. It imposes a cap of $10 billion on the sum of contributions that qualify for a tax credit under this bill. The bill requires the Department of Education, in coordination with the Departments of the Treasury and Labor, to establish, host, and maintain a web portal that (1) lists all eligible scholarship-granting and workforce training organizations; (2) enables contributions to such organizations; (3) provides information about the benefits of this bill; and (4) enables a state to submit and update information about its programs and educational organizations, including information on student eligibility and allowable educational expenses.