Policy Update: Aledade Visits Capitol Hill, Improving Care Management in ACOs, a Closer Look at CMMI Spending and Savings
October 6, 2023

There is waiting till the last minute, and then there is Congress. With no time to spare, Congress managed to reach a temporary budget deal just in time to avert a government shutdown. Unfortunately, we expect this brinkmanship to continue with everything including our immediate priorities such as physician payment fixes and increasing the AAPM bonus, which line up with the end of the year. 

Aledade on Capitol Hill

In the meantime, last month we had a successful Hill Day advocating legislators on both the House and Senate side for physician payment reform and policies that will continue to incentivize and innovate the ACO model. On September 20, we hosted eight physicians in DC which provided a great opportunity for them to tell the story of why they practice independent primary care and how the ACO model is helping improve the health of their patients and communities. 

That same day, NAACOS held their annual Hill Day, and it was great to align on messaging to promote the excellent work ACOs are doing around the country. In addition, we coordinated virtual visits with several Aledade member practices throughout the early fall. Aledade ACO members, if you want to get more involved in primary care advocacy, you are also welcome to email us at  

Join us for our next National Policy Collaborative: Building Momentum for Primary Care Legislation on Tuesday, October 24, 6-7 p.m. ET

The Policy team is hosting our latest installment of the National Policy Collaborative on Tuesday, October 24 at 6 p.m. ET. Join experts and primary care peers from around the country, including our keynote speaker, Chris Koller, president of the Milbank Memorial Fund, for our 60-minute webinar focused on primary care investment opportunities, including the barriers and opportunities available for mandated minimum primary care spend legislation. Building upon the webinar from last year, we will dive deeper into specific steps and strategies for building buy-in as well as introducing and implementing legislation. Register here.

Aledade publishes Health Affairs article on the need for a care management waiver for ACOs

Aledade and Dr. William Shrank, a visiting fellow at Duke Margolis Health Policy Center, recently published an article on the need for better integration between risk-taking primary care providers and more specialized services that provide deeper disease-specific expertise.

The article proposes that CMS waive the initiating, face-to-face relationship requirement for the proposed and existing care management codes for partner organizations that have been designated by an ACO that accepts downside risk. The article also calls for extending the ability to waive copayment/cost-sharing requirements for beneficiaries who would benefit the most from these care management services. 

CBO updates analysis to say CMMI costs the federal government money

You might have seen the recent New York Times article pointing out that Medicare spending is $3.9 trillion below what was expected. A few weeks after that article was published, the Congressional Budget Office (CBO) released a report that says CMMI is not saving the government money as previously projected, but rather is costing money. 

Aledade’s Travis Broome responded on LinkedIn with some analysis of what this all means, emphasizing that the NYT article makes no mention of the ACO movement on savings, and the CBO analysis does not include savings from MSSP, the flagship ACO program.

Travis’s response poses the question, “How can spending be so far below expectations, yet the savings directly attributable to specific models so elusive?” The answer – the ACO model does not just make us cost-conscious; it creates for the first time ever at scale the financial incentive to innovate for better patient health, at the individual practice level and even the individual clinician level.

State Policy Corner: Colorado

Aledade is building its policy presence in Colorado! This month, Aledade sponsored and attended Colorado’s “Governor’s Administration Health Policy Panel” and held our own Colorado “Value-Based Care Summit” policy panel with our stakeholder partners from the Colorado AFP and COPIC Medical Liability Insurance. The Aledade Policy team also visited Boulder Medical Center to learn about practice-level ACO program experiences and build awareness on critical Colorado state policy advocacy areas such as streamlining prior authorization and Colorado’s Health Can’t Wait campaign. 

Aledade ACO members can email with questions on how to get involved in Colorado state policy.