2025 Annual Conference

Darryl Drevna, MA, Senior Director, Regulatory Affairs; Jamie Miller, MBA, Senior Director, Government Relations; and Lauren Lattany, MPS, Director, Government Relations, AMGA
Moderator: Scott Hines, MD, Chief Quality Officer, Optum Tristate, Chief of Quality and Clinical Standards, Optum Health East, Crystal Run Health – Health Transformation and Healthcare

Brief Summary:

In the AMGA Annual Conference session titled "Expect Some Turbulence: Navigating Healthcare’s New Legislative and Regulatory Landscape," AMGA Public Policy team members Lauren Lattany, Jamie Miller, and Darryl Drevna addressed the profound policy disruption under the Trump administration’s second term. With sudden executive orders, sweeping staff changes at CMS and HHS, and an unpredictable political environment, the session emphasized the urgency of legislative advocacy. The panel shared strategies to protect patient access, preserve Medicare reimbursements, and influence long-term policy reforms, including the reauthorization of MACRA.

5 Key Takeaways:

• Policy Volatility Is Real—but Engagement Can Shape Outcomes
  Over 10,000 federal health staff were laid off without warning, disrupting ongoing regulatory efforts. AMGA has responded by positioning members as trusted sources of patient-centered, data-driven insights, which has resulted in stronger relationships with Congressional offices and continued invitations to review draft legislation before it’s introduced. The Administration’s deregulation approach also gives AMGA an opportunity to present HHS/CMS with a list of regulations that impede care delivery and disincentive participation in high value care models and as such, should be eliminated or changed.

• Legislative Fixes Are Incomplete but Still Deliver Impact
  While initial hopes for a Medicare conversion factor patch and APM fix were dashed when Congressional negotiations collapsed, AMGA advocacy did help preserve key short-term wins: elimination of the 4% Medicaire PAYGO cuts, extension of telehealth waivers, and delay of hospital DSH payment cuts. These policy changes stabilized payment flows and access—particularly for patients in rural and underserved areas—and helped health systems avoid deeper revenue losses and service reductions.

• Survey Data and Patient Stories Influence Policy Priorities
  AMGA’s Medicare cuts survey provided lawmakers with real-world evidence: 40% of respondents said cuts were forcing them to reduce services, 12.5% will not accept new Medicare patients, or 13.8 % are consider consolidation. This data not only framed the impact in terms of patient access but also created political urgency, as staffers began to understand the risk of older constituents losing care. These insights are already shaping the reconciliation debate, influencing proposed Medicaid and Medicare payment reforms.

• New Medicaid Advocacy Signals Broader Influence
  For the first time, AMGA is engaging directly in Medicaid policy, anticipating over $800 billion in potential cuts via reconciliation. By documenting how state-level reductions would strain care delivery and state budgets—which have balanced budget requirements—AMGA is equipping members with economic arguments that resonate locally. Early engagement on this front positions AMGA to protect both patients and provider finances as Medicaid becomes a key federal cost-cutting target.

• AMGA's Long-Term Reform Work Aims to Protect Sustainability
  Through the MACRA and Value Task Force, AMGA is laying the groundwork for a reauthorization of MACRA. Priorities include reducing administrative burden, integrating inflation adjustments into Medicare’s fee schedule, and making advanced alternative payment models more accessible. This proactive work ensures that future legislation is shaped by operational realities and sets the stage for long-term financial predictability in a value-driven care model.

In this session, AMGA’s 2025 Acclaim Award recipient will share the details of their award-winning initiative through which their organization is sustainably and equitably achieving the Quadruple Aim.

Fred Horton, MHA, Managing Principal, AMGA's High-Performing Physician Enterprise Program (HPPE); Kelsi O’Brien, MHSA, Principal AMGA's High-Performing Physician Enterprise Program (HPPE), Richard Green, Senior Vice President, Meritas Health Corporation, Patrick Burton, Senior Vice President, Lightbeam Health Solutions

Brief Summary:

This AMGA Annual Conference session, "Leveraging AMGA’s High-Performing Physician Enterprise (HPPE) Assessment to Drive Performance," explored how Meritas Health, a North Kansas City Hospital-affiliated physician group, used AMGA’s HPPE assessment to benchmark performance, reduce financial inefficiencies, and drive cultural transformation. By engaging stakeholders, aligning compensation with productivity, and making strategic operational changes, Meritas improved access, provider satisfaction, and financial sustainability—all while preserving quality and enhancing transparency.

5 Key Takeaways (with ROI examples included):

1. Alignment of Compensation and Productivity Supports Credibility and Efficiency
   Meritas' compensation levels (62nd percentile) and productivity (63rd percentile) showed strong alignment overall. However, deeper analysis revealed 20% of providers in the bottom productivity quartile and Advanced Practice Clinicians (APCs) underperforming (36th percentile productivity vs. 42nd percentile compensation). Addressing these disparities was key to managing compensation equity and strengthening return on investment.

2. Targeted Productivity Improvements Yielded Measurable Financial Gains
   AMGA analysis identified that if underperforming providers reached the median (50th percentile) productivity level at current collection rates, Meritas could gain an additional $10 million in annual collections—or $16 million if productivity improved to the 60th percentile. This concrete opportunity helped reframe internal conversations around performance expectations and system investment.

3. Cultural Shift Around APC Utilization Boosted Volume and Efficiency
   Historically under-leveraged, APCs at Meritas became a key focus area. With clearer expectations and better integration, their expanded roles helped drive a 7% increase in total visits. This shift supported improved provider access without requiring longer hours, thereby protecting provider satisfaction while enhancing throughput.

4. Strategic Moves in Value-Based Care Delivered Direct Financial Impact
   After hiring a population health director and expanding care coordination, Meritas saw its first shared savings return in 2023 under MSSP—enough to reduce the medical group’s operating deficit by $10 million. With 70% annual wellness visit completion and rising quality scores, the group is now actively exploring more advanced risk-based arrangements, positioning itself for sustainable growth in value-based contracts.

5. Greater Transparency Strengthened Stakeholder Trust and Governance
   By involving AMGA directly in board and leadership presentations, Meritas fostered buy-in for difficult but necessary changes. This engagement led to the establishment of a formal physician compensation committee (previously there was little support for establishing a Provider Compensation Committee), more strategic productivity targets (63% of providers now above the 75th percentile), and enhanced board oversight—transforming the practice into a more performance-driven, transparent, and accountable enterprise.