The Bipartisan Healthcare Innovation Caucus, led by Representative Ron Kind (D-WI) and Mike Kelly (R-PA), recently announced that the committee is discussing and developing legislation that would revamp specific provisions of the Stark Law. The provisions under discussion include relaxing existing prohibitions on self-referrals and other relationships that exist in value-based arrangements. Portions under review were initially crafted to eliminate the potential for unethical “kickbacks.” However, healthcare has changed significantly since the Stark Law was passed in 1989, and the restrictions on potential self-referrals are increasingly seen as a barrier to innovation and quality patient care. “Too often, Congress is mired in short-term health care problems instead of pushing the limits on true innovation that will not only improve the quality of care but also lower costs for consumers,” members of the Caucus wrote in a letter explaining the rationale behind the effort. “With the highest health care spending per person in the world at $10,209 per year, the United States needs to be more inventive with payment models and care coordination to drive efficiencies in the health care market.” Innovative payment models have been increasingly seen by healthcare experts on both sides of the aisle as a critical component of lowering healthcare costs and improving patient care. While the restrictions on self-referrals and other complicated relationships were an important concern when the law was passed, the rapid increases in cost of healthcare—and the corresponding burden on Medicare and the federal budget—make a fresh look at the law necessary. “We applaud the efforts of the Caucus,” said Jim Gera, Fusion5 CEO. “Nationally, our healthcare system is defined by our top-flight clinical capabilities. However, inefficient or outdated payment models hinder the ability of those clinicians to deliver top-flight care at an affordable cost. We’ve seen first-hand how revolutionary bundled payment programs are for providers and patients. This effort will help bring payment-model-driven innovation to more hospitals and physician groups, and we strongly support any initiative that leads to healthier patients and financially sound providers.” Want to keep up with the latest developments in value-based care and bundled payments? Follow Fusion5 on LinkedIn, Twitter, and Facebook!

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