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Linda Sánchez and Lynn Jenkins Introduce Rural ACO Provider Equity Act

July 8, 2016
Press Release

WASHINGTON, D.C.– The Medicare Shared Savings Program is an Accountable Care Organization (ACO) through which health care providers join together to coordinate care for Medicare patients, as well as share together in a portion of the cost savings that they achieve. However, rural hospitals and Federally Qualified Health Centers (FQHCs) face severe barriers to participation within the Savings Program.  Representatives Lynn Jenkins (R-KS) and Linda Sánchez (D-CA) introduced the Rural ACO Provider Equity Act to remedy the situation.

“Rural hospitals face challenges that urban healthcare centers never have to deal with. There are fewer resources and doctors available for rural healthcare providers who are trying to ensure high-quality healthcare services for their communities,” said Congresswoman Lynn Jenkins. “Being part of an Accountable Care Organization is a useful tool for healthcare providers to be able to pool resources, and maximize savings and Medicare reimbursement rates. However, rural hospitals can often be forced to miss out on these benefits because they simply don’t have the doctors available to certify their work. This legislation would change that unnecessary requirement, giving rural healthcare providers, such as the 9 FQHCs and 40 RHCs in the Second District, the opportunity to access the resources they need to improve and provide quality care to rural communities.”

“Federally Qualified Health Centers in my district provide critical community-based care for millions of people who are underserved and uninsured. Serving this complex patient population makes care coordination difficult and makes it harder for an FQHC to qualify for cost savings under Accountable Care Organizations,” said Congresswoman Linda Sánchez. “The Rural ACO Provider Equity Act levels the playing field for FQHCs and Rural Health Clinics with other health care providers when it comes to qualifying for ACOs. This bill gives the 11 FQHCs in my district the peace of mind to know they can compete with the larger health care providers for Medicare’s advanced care and payment models.”

Items To Note

  • Under current law, Medicare beneficiaries may receive services in Federally Qualified Health Centers or Rural Health Care Centers. However, these services only count as part of the Medicare Shared Savings Program if the RHC or FQHC sign-off that a physician performed the service.
  • Rural healthcare providers may often have non-physicians perform services, depriving them of the ability to benefit from an ACO partnership.
  • There are 40 RHCs and 9 FHCs within Congresswoman Jenkins’ congressional district in Kansas.
  • There are 11 FHCs within Congresswoman Sánchez’s congressional district in California.