March 14, 2024

Whitehouse, Barrasso, Kilmer, Smith, Gallagher, DelBene Introduce Bipartisan, Bicameral Legislation to Expand Access to Accountable Care Organizations and Coordinated Health Care

Legislation would improve access to care by expanding ACOs to include nurse practitioners, physician assistants, and clinical nurse specialists

Washington, DC – U.S. Senators Sheldon Whitehouse (D-RI) and John Barrasso (R-WY) and Representatives Derek Kilmer (D-WA), Adrian Smith (R-NE), Mike Gallagher (R-WI) and Suzan DelBene (D-WA) today introduced the ACO Assignment Improvement Act, which would expand Medicare Accountable Care Organizations (ACOs) to include nurse practitioners, physician assistants, and clinical nurse specialists.

“Rhode Island’s accountable care organizations have led the way, improving patient care and lowering costs for seniors,” said Whitehouse.  “Our bipartisan legislation would encourage further innovation in health care by removing red tape for patients while delivering coordinated higher quality care to more Medicare beneficiaries.”

“As a doctor from a frontier state, I know how important access to quality health care is for patients no matter where they live,” said Barrasso. “Health care providers in rural areas work hard to ensure our communities receive the care they deserve. Our bipartisan bill will give these providers the support they need to continue that mission. Expanding Accountable Care Organizations to include more providers will keep health care costs low and efficiency high for rural communities in Wyoming and across the country.” 

“No matter where you live, you ought to be able to go to a health care provider,” said Kilmer. “Congress needs to step up and create more options for rural Americans to access value-based, coordinated care so that everyone can get medical care close to home and stay healthy without breaking the bank. The ACO Assignment Improvement Act will do that, and it also rewards health care providers focused on improving the quality of care and putting their patients first.”

“Americans in rural areas such as Nebraska’s Third District depend on physician assistants, nurse practitioners, and clinical nurse specialists, as well as doctors, to provide essential primary care,” said Smith. “The ACO Assignment Improvement Act will afford those serving these rural patients more opportunities to continue providing high quality, coordinated care by removing barriers to participation in Medicare Accountable Care Organizations.”

“Individuals who live in rural areas should not be disadvantaged from receiving affordable, high-quality healthcare. This bipartisan legislation is a commonsense way to get Medicare patients in Northeast Wisconsin better care at a better price by lowering burdens and increasing access to higher quality care organizations,” said Gallagher.

“Providers should be compensated based on the quality of the care they deliver and whether their patients actually get better, instead of the quantity of services provided. Unfortunately, our current fee-for-service system in Medicare still incentivizes quantity over quality in too many cases. If we want to reach our goal of getting all Medicare patients into accountable care organizations by 2030, we need to get serious and enact policies like the ACO Assignment Improvement Act to improve care for those in rural and underserved areas,” said DelBene.

ACOs are groups of hospitals, doctors and health care providers that join together to coordinate care for a certain region.  According to the Centers for Medicare & Medicaid Services, ACOs saved the Medicare program approximately $1.8 billion in 2022, the sixth consecutive year of net savings, by delivering high-quality, coordinated patient care.  In Rhode Island, ACOs care for roughly 41,000 patients and helped contribute to nearly $10 million in savings for Medicare in 2021 and 2022.

Currently, Medicare beneficiaries who want to participate meet with a primary care physician, who will assign them to an ACO.  The ACO Assignment Improvement Act will respect the longstanding relationships patients have with their primary care providers and allow for ACO assignment based on primary care visits with nurse practitioners, physician assistants, and clinical nurse specialists.

“We again thank Senator Whitehouse for his laser-focus on continuing to improve and incentivize the ACO healthcare model of high-quality, coordinated health care for patients and providers especially in rural areas,” said Dr. Edward McGookin, President of Lifespan’s Coastal Medical, an ACO.  This bill recognizes that many patients receive care from non-physician providers and corrects a statutory inequity to ACO care by allowing ACO assignment based on primary care visits with non-physicians like nurse practitioners, physician assistants, and clinical nurse specialists. Coastal Medical and Lifespan applaud the Senator for addressing practical and necessary statutory improvements for ACOs.”

“The ACO Assignment Improvement Act safeguards patients from falling between the many cracks in our healthcare system,” said Noah Benedict, Chief Executive Officer of the Rhode Island Primary Care Physicians Corporation.  “With the growing shortage of physicians, advanced practice practitioners are now critical to providing timely access and care to our patients.  This act aims to ensure every patient that walks into our clinics can benefit from the high-quality, coordinated team-based care ACOs deliver.”    

“The ACO Assignment Improvement Act will ensure community health centers can deliver the benefits of accountable care to their Medicare patients as soon as the person walks in the door,” said Elena Nicolella, President and CEO of the Rhode Island Health Center Association.  “The Act reflects the effective team-based approach Rhode Island’s health centers currently use to deliver high-quality, comprehensive care.”

“The Care Transformation Collaborative of Rhode Island supports the ACO Assignment Improvement Act,” said Debra Hurwitz, Executive Director of Care Transformation Collaborative of Rhode Island.  “The legislation recognizes the important role advanced practice providers play in providing care for Medicare beneficiaries and will remove barriers that delay care.  At a time when Rhode Island and the nation is facing a critical physician shortage, the act responds to the need to reduce physician administrative burden, aligns regulations with care delivery and positively impacts healthcare financing.”

“The American Association of Nurse Practitioners applauds Representatives Kilmer, Adrian Smith and Gallagher and Senators Whitehouse and Barrasso on introducing the ACO Assignment Improvement Act,” saidStephen Ferrara, President of the American Association of Nurse Practitioners (AANP).“Accountable Care Organizations (ACOs) increase Medicare beneficiaries’ access to high quality care and reduce costs. However, while nurse practitioners (NPs) provide a significant portion of care to Medicare beneficiaries, NPs are not full participants in the Medicare Shared Savings Program (MSSP).  This legislation ensures that NPs and their patients are fully included in the MSSP.  Data has shown that full inclusion of NPs is necessary to increase access to the MSSP, especially for underserved populations.  AANP calls on Congress to pass this common sense legislation that will increase Medicare patients’ access to high-quality care.”  

“The American Academy of PAs (AAPA) thanks Sen. Sheldon Whitehouse, Sen. John Barrasso, Rep. Derek Kilmer and Rep. Adrian Smith for introducing the ACO Assignment Improvement Act,” said Folusho E. Ogunfiditimi, DM, MPH, PA-C, DFAAPA, President and Chair of the Board of the American Academy of Physician Associates.  “ACOs help ensure Medicare patients, especially the chronically ill, receive coordinated, high-quality care to optimize their well-being. As clinicians who often serve as a patient’s primary healthcare provider, PAs often participate within ACOs. This critical bipartisan, bicameral legislation will ensure patients receiving care from a PA have an equal opportunity to benefit from participation in an ACO.” 

“The National Rural Health Association (NRHA) thanks Senators Whitehouse and Barrasso for their introduction of the ACO Assignment Improvement Act,” said Alan Morgan, CEO of the National Rural Health Association.  “Physician assistants, nurse practitioners, and clinical nurse specialists are crucial providers of primary care in rural communities. Allowing rural Medicare beneficiaries to be assigned to ACOs when receiving primary care from these practitioners will expand the reach of accountable care in rural areas.”

A summary of the bill is available here.

Press Contact

Meaghan McCabe, (202) 224-2921 Gaby Marks (Barrasso), 202-224-6441 Ian O’Keefe (Kilmer), (202) 225-5916 Logan Williams (Smith), 202-225-6435 Jordan Dunn (Gallagher), (202) 225-5665 Nick Martin (DelBene), (202) 225-6311