AMGA Endorses Chronic Care Management Reform
AMGA and 26 healthcare stakeholder groups endorsed a policy to improve care coordination for the more than 22.5 million Medicare beneficiaries with chronic disease by waiving beneficiary cost-sharing requirements for Chronic Care Management (CCM) services. This endorsement came in the wake of an April 11 Senate Finance Committee hearing on chronic care in the Medicare program.
Calls on Congress to Eliminate Cost-Sharing Requirements
Alexandria, VA – AMGA and 26 healthcare stakeholder groups endorsed a policy to improve care coordination for the more than 22.5 million Medicare beneficiaries with chronic disease by waiving beneficiary cost-sharing requirements for Chronic Care Management (CCM) services. This endorsement came in the wake of an April 11 Senate Finance Committee hearing on chronic care in the Medicare program.
“Chronically ill patients face numerous challenges on a daily basis,” said AMGA President and CEO Jerry Penso, MD, MBA. “But under current policy, cost-sharing requirements prevent patients from benefiting from chronic care management services. Congress should eliminate the cost-sharing requirements from CCM services.”
Medicare began reimbursing clinicians for primarily non-face-to-face chronic care management under a separate code in 2015. Providers and care managers report many positive outcomes for beneficiaries who receive CCM services, including improved patient satisfaction and adherence to recommended therapies, improved clinician efficiency, and decreased hospitalizations and emergency department visits.
However, this billable code came with a cost-sharing obligation for Medicare beneficiaries, which resulted in low utilization of the code. Only about 882,000, or 4%, of Medicare beneficiaries eligible for CCM received these services. AMGA and the other stakeholders strongly recommend Congress eliminate the CCM code’s cost-sharing requirement to help fulfill its potential and remove an unintended barrier for patients.
“We are grateful for the Senate Finance Committee’s leadership on this critical issue and believe removing the beneficiary cost-sharing requirement will improve access and quality of care for millions of senior citizens,” Penso added.
The letter is available on the AMGA website.
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About AMGA
AMGA is a trade association leading the transformation of healthcare 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.
AMGA represents medical groups and integrated systems of care. Its diverse membership includes multispecialty medical groups, integrated delivery systems, accountable care organizations, and other entities committed to improving healthcare outcomes. AMGA advocates for the formation of innovative, clinically integrated systems of care that advance population health, enhance patient experience, and reduce healthcare costs. For more information, please visit www.amga.org.