Sharon Grace
Vice President of Public Relations
703.838.0033 ext. 393

March 3, 2017

AMGA Supports CMS Proposals for Medicare Advantage Encounter Data

Alexandria, VA – AMGA today expressed support for the Centers for Medicare & Medicaid Services’ (CMS’) decision not to increase the weight of encounter data in setting Medicare Advantage (MA) plan risk scores. In comments on the proposed “Advance Notice of Methodological Changes for Calendar Year 2018 Medicare Advantage (MA) Capitation Rates, Part C and Part D Payment Policies and 2017 Call Letter,” CMS proposed to delay a planned increase in the weight given to the Encounter Data System (EDS) for risk scoring for MA plans.

“This delay is a welcome development,” said Donald W. Fisher, Ph.D., CAE, AMGA’s president and chief executive officer. “AMGA and the GAO have pointed out concerns about the accuracy of Medicare Advantage encounter data. It’s encouraging that CMS is acting on our recommendations.”

“AMGA has a strong interest in ensuring the MA program remains a viable option for Medicare beneficiaries.  We are pleased to see that CMS expects plan revenue to increase, as this will help grow plan participation,” Fisher stated.

AMGA also noted that CMS has acknowledged the concerns surrounding the benchmark caps. MedPAC and others have recommended that the caps be eliminated.  “Recognizing the unintended consequences of the benchmark caps is a first step,” Fisher said.  “We’re ready to work with CMS and other stakeholders to ensure all Medicare beneficiaries can choose a high-value, quality MA plan.”

AMGA will closely review the final MA call letter.

AMGA’s letter is available on our website.

About AMGA
AMGA is a trade association leading the transformation of health care in America. Representing multispecialty medical groups and integrated systems of care, we advocate, educate, innovate, and empower our members to deliver the next level of high performance health. AMGA is the national voice promoting awareness of our members’ recognized excellence in the delivery of coordinated, high-quality, high-value care. More than 175,000 physicians practice in our member organizations, delivering care to one in three Americans. For more information, visit