House leadership urged to address impending MACRA changes

Nearly 30 representatives yesterday urged House leaders to modify in the next COVID-19 response package impending thresholds for qualifying participants in Advanced Alternative Payment Models, which they said threaten to “derail” the movement to value-based care under the Medicare Access and CHIP Reauthorization Act.

“It has become clear that COVID-19 will make it more challenging for many of these providers to meet the law’s current thresholds due to shifts in care,” the House members wrote. “According to data recently released by the Centers for Medicare & Medicaid Services, on average, providers missed even the current QP threshold (50%) and are nowhere near the heightened threshold (75%) required by statute in 2021. It is critical for seniors that APMs continue in 2021 and beyond. Providers participating in APMs are conducting care coordination strategies that are needed now more than ever.”

Reps. Suzan DelBene, D-Wash., Roger Marshall, R-Kan., Peter Welch, D-Vt., and Darin LaHood, R-Ill., spearheaded the letter with support from AHA and other national hospital and physician organizations.