HHS Endorses First Emergency Medicine-Focused Medicare Alternative Payment Model Developed by ACEP

The American College of Emergency Physicians (ACEP) is very pleased that the Secretary of the Department of Health and Human Services (HHS) Alex Azar has publicly expressed his support of the Acute Unscheduled Care Model (AUCM)—the first emergency medicine-focused Medicare alternative payment model (APM). Developed by ACEP and recommended by the Physician-Focused Payment Model Technical Advisory Committee (PTAC)—the AUCM would fill a gap in available APMs for emergency physicians.

Structured as a bundled payment model, the AUCM would improve quality and reduce costs by allowing emergency physicians to accept some financial risk for the decisions they make around discharges for certain episodes of acute unscheduled care. As Medicare and other payers move away from fee-for-service toward more value-based care, the AUCM enables emergency physicians to play a leading role in managing this transition.

In HHS’ official response to PTAC, Secretary Azar asks the Centers for Medicare & Medicaid Services (CMS)’ Innovation Center (CMMI) to look into incorporating core concepts of AUCM into the APMs it is developing. Secretary Azar specifically noted that AUCM is a “creative proposal…that focuses on the safe discharge of patients, follow-up care for 30 days post-ED visit, and hospitalizations or other avoidable post-ED visit events and their associated costs.” The Secretary also noted that he is “encouraged by submitters like ACEP who continue to help drive transformative innovation in American health care toward a value-based delivery system.”

The Secretary’s endorsement of the AUCM is an important step toward enhanced quality reporting and value-based care in emergency medicine and paves the way for emergency physicians to finally be in a Medicare APM that is meaningful to them and their patients. ACEP looks forward to working with CMMI as it carries out the HHS Secretary’s request.