Issues

2016 Issue Briefs

2015 Capitol Hill Day Issue Briefs

Some of AMGA's priority issues include:

Affordable Care Act Implementation and Information

  • Accountable Care Organizations

  • Centers for Medicare and Medicaid Services Rulemaking on the Affordable Care Act

  • Value-Based Modifier Payment

Medicare

  • Sustainable Growth Rate (SGR)

  • Medicare Advantage

Regulatory Affairs and Rulemaking

  • Centers for Medicare and Medicaid Services (CMS)

  • Medicare and Medicaid Electronic Health Records Incentive Program

2014 Issue Briefs

2013 Issue Briefs

Other Issues

High-Performing Health Systems
As health reform continues throughout the country, we have seen a lot of confusion about what constitutes a “high-performing health system,” and why these systems should be incentivized. Because our members are on the cutting edge of healthcare quality and innovation, AMGA decided to take a leadership position in defining a high-performing health system (HPHS) to educate legislators, insurers, and the public on the unique attributes of these systems and to aid provider organizations in their efforts to improve patient care. AMGA is also using this definition to advocate for Medicare reimbursement for health systems that meet the criteria of the definition

AMGA Definition of High-Performing Health Systems

Diagnostic Imaging in a Medical Group Setting
For the past several years, there have been attempts to amend or remove certain provisions from the in-office ancillary services exception (IOASE) to the Stark law. Since the Stark law permits multispecialty medical groups to self-refer patients for advanced diagnostic imaging services, AMGA has, and will continue to oppose, any legislation that would restrict the ability of multispecialty medical groups and other organized systems of care to coordinate the care of their patients by eliminating or restricting their ability to provide advanced diagnostic imaging services.

Any legislation that seeks to remove advanced diagnostic imaging services from the in-office ancillary services exception (IOASE) to the Stark law and would seriously impair our medical groups' ability to provide the entire continuum of care, engage in shared decision-making, and improve the overall patient experience. AMGA member medical groups have spent enormous amounts of time redesigning internal processes, in collaboration with their group's radiologists, to ensure that advanced diagnostic imaging services are furnished to patients only when medically necessary.

Many AMGA members utilize decision support tools to ensure that clinical decision-making is supported by evidence before ordering these services. Data from our members shows that due to their investment in these decision support tools, they have been able to achieve significant cost savings for their groups and for the healthcare system as a whole. Many of our members have voluntarily adopted stringent pre-certification procedures which have contributed to these savings. Several of our member medical groups have also indicated that computerized tomography/magnetic resonance imaging (CT/MRI) revenue is declining even while the number of Medicare beneficiaries they treat is increasing.