Since APMs have to show “savings for Medicare within a short timeframe, they are often terminated instead of being improved and expanded nationwide,” says the AMA explainer.

A U.S. Government Accountability Office report on practices in rural or underserved areas noted that “many lack the capital to finance the upfront costs of transitioning to an APM and face challenges acquiring or conducting data analysis necessary for participation,” the AMA notes.

“There is also no nationwide primary care medical home model in Medicare, despite multiple Medicare demonstrations of this model, so patients insured by Medicare are not benefiting from the improvements in preventive care, health care quality and management of chronic conditions that medical homes can provide.”

The AMA supports H.R. 5013/S. 3503, the Value in Health Care Act, which would restore the APM incentive payments to 5% for two years and establish a 50% revenue threshold that physicians in value-based care models must meet to qualify for the bonuses over the same time frame.

The bill, among other things, would give the Health and Human Services (HHS) secretary the authority to further increase the revenue threshold, but at a pace of no more than 5% in any single year.