PROVIDENCE – U.S. Sens. Sheldon Whitehouse, D-R.I., and John Barrasso, R-Wyo., have introduced bipartisan legislation known as the ACO Assignment Improvement Act.
The legislation expands participation in Medicare’s coordinated-care programs by ensuring Medicare recognizes the care patients receive from nurse practitioners, physician assistants and clinical nurse specialists when determining their participation in an accountable care organization, according to a news release.
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“Rhode Island’s accountable care organizations continue to improve patient care while lowering costs,” Whitehouse said in a statement. “Many Rhode Islanders see nurse practitioners and physician assistants for their primary care. With our bipartisan bill, these same patients will now have access to care from providers who are rewarded for good patient outcomes.”
ACOs are groups of hospitals, doctors and other health care providers that work together to coordinate care for patients. ACOs saved the Medicare program approximately $2.4 billion in 2024, according to the Centers for Medicare & Medicaid Services.
For many Americans – especially those living in rural communities – their closest and most consistent primary care relationship is with a nurse practitioner or physician assistant, according to the release. However, current Medicare rules typically assign patients to an ACO only if they receive care from a physician. The ACO Assignment Improvement Act updates this policy to ensure patients who rely on nurse practitioners, physician assistants and clinical nurse specialists for primary care can participate in the ACO model alongside those who see physicians.
“This important bill recognizes that many patients receive care from non-physician providers and corrects a statutory inequity to ACO care by allowing patient assignment based on primary care visits with key members of care teams such as nurse practitioners, physician assistants, and clinical nurse specialists,” Dr. Edward McGookin, chief of primary care at Brown Health Medical Group Primary Care, said in a statement.
“Our patients often rely on nurse practitioners, physician assistants, and clinical nurse specialists because of limited access to physicians,” Noah Benedict, CEO and president of Rhode Island Primary Care Physicians Corp., said in a statement. “Recognizing these visits in the attribution process allows us to better manage patients’ care, close gaps in preventive services, and ultimately improve outcomes while reducing costs.”
Valerie J. Fuller, president of the American Association of Nurse Practitioners, commended Whitehouse and Barrasso for their work on the legislation.
“The importance of passing this legislation has continued to grow as more patients are seeing NPs, and over half of NPs in Medicare participate in the Medicare Shared Savings Program,” Fuller said in a statement, adding there are more than 461,000 nurse practitioners nationwide. “NPs are essential in the transition to value-based care, and removing this barrier will increase patient access to accountable care and improve on the success of the program.”
