Bill Overview
Title: Preserving Patient Access to Value-Based Care Act
Description: This bill extends certain incentive payments for health professionals who participate in eligible alternative payment models under Medicare.
Sponsors: Sen. Barrasso, John [R-WY]
Target Audience
Population: People receiving care under Medicare
Estimated Size: 60000000
- Medicare is a federal program in the United States, primarily serving people over 65 years of age.
- The bill impacts health professionals participating in eligible alternative payment models.
- The models include Accountable Care Organizations (ACOs) and other value-based payment structures that cover various healthcare providers.
- It extends incentives, which aim to influence the type of care Medicare beneficiaries receive.
- Millions of Americans are enrolled in Medicare, indicating a large population could be impacted.
- Healthcare professionals' incentives will potentially shape the care delivery methods.
Reasoning
- The policy will predominantly benefit Medicare beneficiaries, impacting those who are over 65 years old, have disabilities, or suffer from certain diseases.
- Healthcare professionals involved in alternative payment models will likely adjust their care delivery to maximize the incentives, aiming for improved care quality and efficiency.
- A proportion of the population might not directly observe personal benefits but could experience subtle improvements in care standards.
- Only a subset of healthcare providers might fully engage with these incentives, limiting the breadth of the impact.
- The budget constraints suggest that while significant, the total funds available will limit how widespread and deep the incentives can be distributed.
- Healthcare systems in more developed regions might adapt better to the policy due to existing infrastructure, potentially leaving rural areas less impacted.
Simulated Interviews
Retired teacher (Miami, FL)
Age: 67 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 15/20
Statement of Opinion:
- I hope my doctors will be encouraged to coordinate better care for my diabetes.
- It's great if this policy pushes more personalized care.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 4 |
Retired farmer (Rural Alabama)
Age: 72 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 5.0 years
Commonness: 10/20
Statement of Opinion:
- I'm worried it won't make a difference in my small town.
- Good care is hard to find out here regardless of policies.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 4 |
| Year 2 | 4 | 4 |
| Year 3 | 4 | 4 |
| Year 5 | 4 | 3 |
| Year 10 | 4 | 3 |
| Year 20 | 3 | 2 |
Actress (Los Angeles, CA)
Age: 65 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 20.0 years
Commonness: 18/20
Statement of Opinion:
- I believe this could improve the options for preventative care.
- Hope it encourages my doctors to offer more holistic approaches.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 5 |
| Year 20 | 8 | 5 |
Retired lawyer (New York, NY)
Age: 80 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 12/20
Statement of Opinion:
- I already get pretty good care; I'm skeptical about how much better it can get.
- Lots of policies seem to come and go without much difference.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 5 |
Retired nurse (Houston, TX)
Age: 69 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 17/20
Statement of Opinion:
- I think it can help to keep more doctors engaged and caring better.
- Expecting some better follow-up on treatments.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 6 | 5 |
Retired engineer (Chicago, IL)
Age: 74 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 15.0 years
Commonness: 19/20
Statement of Opinion:
- Policies that push for more efficient systems are good.
- This might help in keeping routine check-ups more structured.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 6 | 5 |
Retired software developer (San Francisco, CA)
Age: 68 | Gender: other
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 14/20
Statement of Opinion:
- Healthcare should evolve with technology; this seems a step.
- Hope it actually translates into better digital health integration.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 7 | 5 |
Retired school principal (Atlanta, GA)
Age: 90 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 3.0 years
Commonness: 16/20
Statement of Opinion:
- I'm not sure this will change much in my situation.
- I rely on constant care, so improvements elsewhere might not reach me.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 4 | 4 |
| Year 3 | 4 | 4 |
| Year 5 | 4 | 3 |
| Year 10 | 4 | 3 |
| Year 20 | 3 | 2 |
Retired artist (Seattle, WA)
Age: 70 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 14/20
Statement of Opinion:
- Having flexible and well-coordinated care would be beneficial.
- Depends on how well it's implemented, especially across different states.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 6 | 5 |
| Year 20 | 6 | 5 |
Retired government worker (Boston, MA)
Age: 66 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 15.0 years
Commonness: 20/20
Statement of Opinion:
- I hope this pushes for innovations and better regular care.
- Good policies can lead to continuous improvements; I support this.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 6 | 5 |
Cost Estimates
Year 1: $450000000 (Low: $400000000, High: $500000000)
Year 2: $460000000 (Low: $410000000, High: $510000000)
Year 3: $470000000 (Low: $420000000, High: $520000000)
Year 5: $500000000 (Low: $450000000, High: $550000000)
Year 10: $550000000 (Low: $500000000, High: $600000000)
Year 100: $700000000 (Low: $650000000, High: $750000000)
Key Considerations
- Variability in Medicare spending trends could affect cost and savings estimates.
- The bill’s impact relies heavily on the extent of provider participation in alternative payment models.