AMGA Urges CMS to Continue Move to Value During COVID-19 Pandemic; Calls for Changes in 2021 Medicare Shared Saving Program

Alexandria, VA – AMGA today recommended that the Centers for Medicare & Medicaid Services (CMS) reverse its decision to forgo the 2021 application cycle for the Medicare Shared Savings Program (MSSP) and maintain the progression through levels of risk in the program. While CMS has taken several steps to support healthcare providers during the coronavirus (COVID-19) public health emergency, the transition to value-based care should continue. Providers have adopted new care management strategies because of the pandemic, and the lessons learned will inform care delivery models in the future. Those providers that voluntarily wish to enter the MSSP should have an opportunity to do so.  

“CMS has instituted a number of changes to support providers and their patients during the national public health emergency,” said AMGA President and CEO Jerry Penso, M.D., M.B.A. “But the work to move our delivery system to one that prioritizes value needs to continue. We cannot afford to pause the progress that we have made in the transition to value-based care, and cancelling the 2021 application cycle for the MSSP will unnecessarily inhibit that transition.”

CMS’ interim final rule also provides those Accountable Care Organizations (ACOs) participating in the BASIC track of the MSSP with an option to maintain their current risk level for an additional year. However, those ACOs that select this option will not advance to the next level of risk in sequential order. For example, a “Level B” ACO that selects to remain at Level B will move to Level D the following year, bypassing Level C.  While AMGA supports the option for ACOs to remain in their current risk level, CMS should not then move them past a stage and into a more advanced risk level automatically. It is important that ACOs continue to assume additional risk incrementally.

The letter 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.