Regulations under the Medicare Access and CHIP Reauthorization Act could create more challenges for long-term or terminally ill patients, eldercare advocates said last week.

Seniors are often overlooked in payment reform, said Joanne Lynn, M.D., director of the Altarum Institute’s Center for Elder Care and Advanced Illness, who spoke before the Physician-Focused Payment Model Technical Advisory Committee, according to a Modern Healthcare account. The committee is helping HHS evaluate payment models for the new system.

Alternative payment models will be challenging for nursing homes that are not part of larger health systems, and more awareness is needed of that provider group, Lynn said.

Another physician testified that comparing geriatricians to other primary care providers doesn’t take into account vulnerable populations. An AARP lobbyist said provider tracks in MACRA or alternative payment models do not adequately address long-term care.

Speaking at the American Hospital Association’s membership meeting, Center for Medicare & Medicaid Services head Andy Slavitt said new payment models are still in the early stages of discussion, Healthcare Finance News reported. He said electronic health record interoperability is a top priority.