AMGA Endorses ACO Benchmark Improvement Legislation

Alexandria, VA – AMGA today endorsed legislation, sponsored by Sen. Catherine Cortez Masto (D-NV) and Sen. Pat Roberts (R-KS), which would improve the method the Centers for Medicare and Medicaid Services (CMS) uses to calculate the regional adjustment that factors into an Accountable Care Organization’s (ACO’s) benchmark in the Medicare Shared Savings Program (MSSP). We believe the legislation, the Rural ACO Improvement Act (S.2648), will remedy a longstanding issue regarding benchmark calculations for ACOs that have inhibited the move to value-based care.

Currently, CMS includes all patients in a region in the calculation of fee-for-service expenditures. This approach effectively penalizes ACOs that are the most efficient providers in their market and makes it more difficult for them to earn shared savings. Removing the ACO population from the regional adjustment calculation ensures that the ACO is not competing against itself if it performs well relative to its market. AMGA believes this change will encourage ACOs to participate in the MSSP and reward them for performing well then they reduce costs and improve quality.

“AMGA commends Congress for its attention to this critical matter and recommends that this policy pass as soon as possible so that providers can continue to transition to value-based care,” said AMGA president and CEO Jerry Penso, M.D., M.B.A. “Our members are strong supporters of the Medicare Shared Savings Program, which seeks to move our delivery system to one that rewards value and outcomes. This important legislation will ensure that our members are not penalized for being efficient providers and offer them a realistic opportunity to earn shared savings, while continuing to improve patient outcomes.”

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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.