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House Energy and Commerce Health Subcommittee Examines Value-Based Models in Medicare Program

Yesterday, the Health Subcommittee of the House Energy and Commerce Committee (E&C), chaired by Rep. Michael Burgess (R-TX), held a hearing titled “Examining Barriers to Expanding Innovative, Value-Based Care in Medicare,” which examined ways to evaluate and increase the use of value-based models and arrangements in the Medicare program. Six witnesses representing provider groups and accountable care organizations (ACOs) testified before the committee about various ways that Congress can help ease the transition of healthcare providers to new payment systems under MACRA that emphasize quality over volume. They reminded the committee that the MACRA statute created incentives to participate in the new payment systems, but that other current laws, as well as regulations, often get in the way of those objectives. Issues discussed included the Stark Law and how it prohibits physicians from referring Medicare patients to another provider if both providers have a financial relationship. A complete list of witnesses and their testimony can be found on the hearing website, as can a link to watch the hearing in its entirety.

In the hearing announcement last week, Chairman Burgess called the hearing “an important opportunity to have a dialogue about how we can better adapt as healthcare moves away from fee-for-service models and toward value-based reimbursement.” As you are aware, ASCRS has long advocated for maintaining a Medicare Part B fee-for-service option, as there are currently no Advanced APMs for ophthalmology. ASCRS Government Relations Committee Chair Parag Parekh, MD, MPA, testified on behalf of the Alliance of Specialty Medicine before the same committee in July at a hearing titled “MACRA and MIPS: An Update on the Merit-Based Incentive Payment System.” During his testimony, Dr. Parekh thanked Congress for passing technical corrections to the MACRA statute and emphasized the importance of maintaining a fee-for-service option in Medicare. 

We will keep you updated.