Whitehouse, Barrasso Introduce Legislation to Expand Access to Quality-Driven Health Care

Washington, DC - U.S. Senators Sheldon Whitehouse (D-RI) and John Barrasso (R-WY) have introduced bipartisan legislation to expand access to quality-driven health care. The ACO Assignment Improvement Act expands participation in Medicare's coordinated-care programs by ensuring Medicare recognizes the care patients receive from nurse practitioners, physician assistants, and clinical nurse specialists when determining their participation in an Accountable Care Organization (ACO). This change will help Medicare patients receive more seamless, coordinated, and high-quality care.

"Rhode Island's accountable care organizations continue to improve patient care while lowering costs," said Whitehouse. "Many Rhode Islanders see nurse practitioners and physician assistants for their primary care. With our bipartisan bill, these same patients will now have access to care from providers who are rewarded for good patient outcomes."

ACOs are groups of hospitals, doctors, and other health care providers who work together to coordinate care for patients. ACOs are a proven model that improves care coordination and quality. According to the Centers for Medicare & Medicaid Services, ACOs saved the Medicare program approximately $2.4 billion in 2024-the eighth consecutive year of net savings and highest amount of savings since the inception of the program-by delivering high-quality, coordinated patient care.

For many Americans-especially those living in rural communities-their closest and most consistent primary care relationship is with a nurse practitioner (NP) or physician assistant (PA). However, current Medicare rules typically assign patients to an ACO only if they receive care from a physician. The ACO Assignment Improvement Act updates this policy to ensure that patients who rely on NPs, PAs, and clinical nurse specialists for primary care can participate in the ACO model alongside those who see physicians.

"We are appreciative of Senator Whitehouse's focus and passionate support of the ACO model to create a system for high-quality, coordinated health care that is patient centered," said Dr. Ana Tuya-Fulton, President and COO of Integra and Chief Population Health Officer of Care New England. "This legislation will help recognize the important role advanced practice clinicians play in providing care for Medicare beneficiaries, and will allow ACO alignment based on primary care visits with advance practice clinicians."

"We are grateful to Senator Whitehouse for his continued efforts to improve and incentivize the ACO healthcare model of high-quality, coordinated health care for patients and providers," said Edward McGookin, MD, MHCDS, FAAP, Chief of Primary Care of Brown Health Medical Group Primary Care, an ACO."This important bill recognizes that many patients receive care from non-physician providers and corrects a statutory inequity to ACO care by allowing patient assignment based on primary care visits with key members of care teams such as nurse practitioners, physician assistants, and clinical nurse specialists."

"As a primary care organization serving complex and vulnerable populations, we welcome the reintroduction of the ACO Assignment Improvement Act as a step toward ensuring patients receive access to coordinated care no matter which provider they see first," said Noah Benedict, President and CEO of Rhode Island Primary Care Physicians. "Our patients often rely on nurse practitioners, physician assistants, and clinical nurse specialists because of limited access to physicians. Recognizing these visits in the attribution process allows us to better manage patients' care, close gaps in preventive services, and ultimately improve outcomes while reducing costs."

"As patient needs increasingly outpace provider capacity, innovative legislation like this is essential to strengthening access to primary care," said Robert Millette, Senior Vice President of Astrana Health - RI. "By recognizing and empowering the vital contributions of nurse practitioners, physician assistants, and other providers, this bill will help address the crisis and ensure patients receive high-quality, timely, and accessible care."

"ACOs help ensure Medicare patients, especially the chronically ill, receive coordinated, high-quality care," said Todd Pickard, DMSc, PA-C, DFAAPA, FASCO, President and Chair of the American Academy of Physician Associates. "As clinicians who serve as primary healthcare providers, PAs often participate within ACOs. This critical bipartisan legislation will ensure patients receiving care from a PA will benefit from participation in an ACO."

"The American Association of Nurse Practitioners (AANP), on behalf of the over 461,000 nurse practitioners (NPs) nationwide, commends Senators Barrasso and Whitehouse for their leadership on the ACO Assignment Improvement Act of 2025," said Valerie J. Fuller, PhD DNP, President of the American Association of Nurse Practitioners. "The importance of passing this legislation has continued to grow as more patients are seeing NPs, and over half of NPs in Medicare participate in the Medicare Shared Savings Program. NPs are essential in the transition to value-based care, and removing this barrier will increase patient access to accountable care and improve on the success of the program."

The bill reinforces the longstanding relationships patients have with their trusted primary care providers by allowing ACO assignment based on visits with these clinicians. This change expands access to the coordinated, high-quality care that ACOs are designed to deliver.