AMGA Endorses Bipartisan Bill to Fix Benchmarking Calculation for Rural ACOs

Contact:

Sharon Grace
Chief Communications Officer
703.838.0033 ext. 393
sgrace@amga.org

November 21, 2019,

Alexandria, VA – AMGA today endorsed a bill that would refine the Centers for Medicare & Medicaid Services’ (CMS) methodology used to calculate benchmarks for accountable care organizations (ACO) participating in the Medicare Shared Savings Program (MSSP). AMGA thanks Rep. Jodey Arrington (R-TX), Rep. Suzan DelBene (D-WA), Rep. Roger Marshall (R-KS), and Rep. Ami Bera (D-CA) for leading this bipartisan effort.

Currently, CMS includes all beneficiaries in the regional adjustment factor that is used to calculate an ACO’s benchmark, which disadvantages ACOs that perform well relative to the rest of their region and makes it more difficult for them to earn shared savings. H.R. 5212, the Accountable Care in Rural America Act, would remedy this issue by removing an ACO’s population from CMS’ regional adjustment calculation. This will help ensure the ACO is not penalized for making improvements in its market and is not competing against itself if it performs well relative to that market. AMGA believes this change will encourage more ACOs to participate in the MSSP and reward them for delivering higher quality, lower cost care, regardless of their geographic location.

“ACOs have proven to be a promising mechanism for delivering higher quality, lower cost care,” said AMGA President and CEO Jerry Penso, M.D., M.B.A. “But, how CMS currently sets benchmarks could have the undesired effect of discouraging ACOs from participating in the program. Removing this design flaw will help providers succeed in the MSSP, a vital program in the transition to value-based care. AMGA commends Congress for its attention to this longstanding issue.”

AMGA previously endorsed this bill in October, when it was introduced in the senate.

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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.

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