AMGA Endorses Proposed Changes in Medicare Advantage Program
Alexandria, VA – AMGA today expressed support for a number of Centers for Medicare & Medicaid Services’ (CMS’) proposals in both its CY 2023 Medicare Advantage (MA) Advanced Notice and its proposed rule (CMS-4192-P). Medicare Advantage is an increasingly important financing option for AMGA members and their patients. In comments on the two proposals, AMGA endorsed policies designed to increase transparency in the MA program and begin the process of improving health equity.
“AMGA members continue to partner with Medicare Advantage plans because of how the program supports the transition to value-based care,” said Jerry Penso, M.D., M.B.A., AMGA president and CEO. “CMS’ proposals are building on that framework, while taking a step to help providers and plans tackle disparities in health care.”
In a letter to CMS on the Advance Notice, AMGA endorsed CMS’ proposal to apply a coding adjustment factor of 5.90%, the statutory minimum. AMGA also expressed support of CMS working to incorporate social determinants of health into the program’s risk-adjustment feature. Before moving forward with any changes, AMGA recommended that CMS explore the effect of including social determinants of health in the model.
For the proposed rule, CMS is proposing to increase transparency by reinstating an earlier requirement that plans submit information on their provider networks instead of simply attesting to network adequacy requirements. AMGA endorsed this change to help ensure patients understand their provider networks. The rule also would require special needs plans to include questions about social determinants in their health risk assessments (HRAs). AMGA is recommending that CMS work with the stakeholder community to develop any questions included in the HRAs.
AMGA’s comments on the Medicare Advantage (MA) Advance Notice is available here, and its comments on the “Medicare Program; Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs” (CMS-4192-P) is available here.
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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.