Premier Offers Input on MACRA Reform to Inform House Health Committee Debate

The House Energy and Commerce Health Subcommittee held a hearing on May 20, 2026 to evaluate the Medicare Access and CHIP Reauthorization Act (MACRA) and explore options to stabilize Medicare physician payments. Premier provided recommendations to the committee to support the development of legislation that accelerates the nation’s transition to value-based care. Premier outlined several opportunities to strengthen the MACRA and expand incentives for providers to participate in alternative payment models (APMs). In its detailed recommendations, Premier urged Congress to:

• Extend the APM bonus for multiple years;
• Grant CMS authority to adjust the Qualifying APM Participant (QP) threshold;
• Direct CMS to address burdensome quality reporting and promoting interoperability requirements for accountable care organizations (ACOs);
• Strengthen the Medicare Shared Saving Program (MSSP);
• Require stronger oversight of fraud/waste/abuse and the impact to providers participating in total cost of care APMs;
• Set clear parameters for moving beyond testing to nationally scale successful models;
• Extend the Congressional Budget Office’s scoring window to more accurately capture savings from preventive health initiatives;
• Eliminate cost sharing for attributed beneficiaries who require chronic care management to ease the financial burden;
• Establish flexibilities to develop rural-specific APMs; and
• Bolster physician payment by accounting for inflation.