Bipartisan Bill Expands Medicare ACO Access to Nurse Practitioners and PAs

U.S. Senators John Barrasso and Sheldon Whitehouse have introduced the ACO Assignment Improvement Act, a bipartisan proposal aimed at expanding Medicare's Accountable Care Organizations (ACOs) to include care provided by nurse practitioners (NPs), physician assistants (PAs), and clinical nurse specialists. This legislative change intends to recognize healthcare services from these providers in determining patient assignment to ACOs, thereby broadening access to coordinated, high-quality care within Medicare's value-based care framework. The bill responds to the current Medicare policy that typically assigns patients to ACOs based only on their primary care received from physicians. Considering that many Medicare beneficiaries, particularly in rural areas, rely on NPs and PAs as their principal healthcare providers, this policy update ensures their inclusion in Medicare's coordinated care models. This move is expected to strengthen patient-provider relationships and improve care continuity. ACOs are networks of healthcare providers that collaborate to deliver efficient and quality care, which has resulted in significant Medicare savings—in 2024 alone, CMS reported $2.4 billion in savings after eight consecutive years of net gains. By incorporating non-physician primary care providers into ACOs, the legislation aligns Medicare incentives with the evolving landscape of primary care delivery and value-based healthcare. Healthcare professional organizations representing NPs and PAs have endorsed the legislation, highlighting their growing role in Medicare Shared Savings Programs and their critical function in managing chronic illnesses. The legislation is seen as a step toward removing barriers to patient access and enhancing the impact of coordinated-care models. This policy change reflects broader trends in healthcare emphasizing team-based care and the utilization of all qualified providers to optimize outcomes. It supports Medicare's goals of lowering costs, improving patient health outcomes, and simplifying access to care across diverse patient populations.