Bipartisan Bill Expands Medicare ACO Participation to NPs and PAs

U.S. Senators John Barrasso and Sheldon Whitehouse introduced the ACO Assignment Improvement Act, bipartisan legislation aimed at enhancing Medicare's coordinated care programs by expanding recognition to nurse practitioners, physician assistants, and clinical nurse specialists in the Accountable Care Organization (ACO) patient attribution process. This legislative change addresses a significant limitation in current Medicare rules that typically assign patients to ACOs only if they receive primary care from physicians, excluding many who rely on advanced practice providers, particularly in rural areas. ACOs, which comprise hospitals, physicians, and other healthcare providers working together to coordinate patient care, have demonstrated substantial cost savings for Medicare, totaling approximately $2.4 billion in 2024 alone. By including nurse practitioners and physician assistants in patient assignment criteria, the bill aims to improve access to coordinated, high-quality care and continue the trajectory of savings and enhanced patient outcomes within Medicare's value-based care framework. This expansion aligns with ongoing efforts to optimize care delivery, reduce administrative barriers, and support diverse healthcare provider roles in managing patient populations under Medicare. The proposed policy shift could particularly benefit primary care accessibility in underserved regions, where advanced practice providers often serve as the primary healthcare contact. The legislation's bipartisan nature underscores the cross-party recognition of the evolving healthcare workforce and the need to adapt Medicare policies accordingly.