Legislation to create a Medicare value-based purchasing program for post-acute care “is too narrowly focused on cutting provider payment rather than promoting ‘value’,” AHA said in a letter today to leaders of the House Ways and Means Committee. “AHA members are deeply engaged in efforts to provide more accountable care that delivers greater value,” wrote AHA Executive Vice President Tom Nickels. “However, by using only the [Medicare spending per beneficiary] measure, the PAC VBP program appears focused on only the cost side of the value equation…Without a more balanced, budget neutral approach that includes an assessment of quality, the PAC VBP program appears to function as a mechanism to cut provider payments in perpetuity, rather than primarily as a way to promote value.” The program would withhold 3% of post-acute care payments in FY 2020, rising to 8% in FY 2025 and beyond, which AHA said is “too high” and “out of step with other Medicare VBP programs.” In addition, the proposed scoring methodology “would tie too much of an individual provider’s performance to the actions of other providers that are beyond their control,” AHA said.

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