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December 2, 2014
Statement from American Medical Group Association (AMGA) Regarding CMS Proposals to Improve Accountable Care Organizations
Yesterday, the Centers for Medicare & Medicaid Services (CMS) released a new proposal to strengthen the Medicare Shared Savings Program for Accountable Care Organizations (ACOs). The proposed rule reflects input from program participants, experts, consumer groups, and the stakeholder community at large.
Donald W. Fisher, Ph.D., CAE, president and chief executive officer of the American Medical Group Association (AMGA), made the following comment:
The American Medical Group Association (AMGA) is pleased that the Centers for Medicare and Medicaid Services (CMS) has released a proposed rule to make refinements to the current framework of the Medicare Shared Savings Program. The CMS proposals reflect that the agency is being responsive to the input it has received from healthcare providers and other stakeholders concerning the operational and financial challenges that threaten the success of the program.
AMGA supports many of the proposed changes, including the proposal to allow Accountable Care Organizations (ACOs) that are in the one-sided model an additional agreement period before transitioning into the two-sided model, which requires them to assume downside risk. Yet, ACOs should not be further penalized for deferring risk-taking, because it requires significant time to develop the new cultural, clinical, financial, analytic, and administrative competencies needed to manage population health. We also appreciate the proposed expansion of care coordination tools that will be made available to ACOs, such as beneficiary attestation, use of telehealth, and additional flexibility in making post-acute care referrals. However, these tools should be made available to all ACOs, not only those that are assuming risk. All ACOs, whether one-sided or two-sided, must make substantial investments to establish a successful program, and this should be recognized and rewarded in the regulatory framework.
While we are pleased to see that CMS has taken note of the extensive input it has received from ACO stakeholders, the proposals offered yesterday will need additional refinement to ensure the future viability of the Medicare Shared Savings Program. AMGA looks forward to providing recommendations to the agency that will help to realize the program’s promise of improving patients’ experiences and the quality of health care they receive, reducing overall costs, and rewarding ACOs appropriately.
The American Medical Group Association (AMGA) represents some of the nation's largest, most prestigious medical practices, independent practice associations, accountable care organizations, and integrated healthcare delivery systems. AMGA's mission is to support its members in enhancing population health and care for patients through integrated systems of care. More than 150,000 physicians practice in AMGA member organizations, providing healthcare services for 120 million patients (approximately one in three Americans). Headquartered in Alexandria, Virginia, AMGA is the strategic partner for these organizations, providing a comprehensive package of benefits, including political advocacy, educational and networking programs, publications, benchmarking data services, and financial and operations assistance. www.amga.org