AMGA Recommends Reforms to Support Value-Based Care

Alexandria, VA – AMGA today recommended that the Centers for Medicare & Medicaid Services (CMS) reform a number of regulations and policies to ensure they support providers’ ability to deliver care in value-based models. In response to CMS’ Request for Information on reducing administrative burden, AMGA offered detailed policy recommendations designed to reduce Medicare programs’ regulatory complexity so our member providers are better able to focus on providing the best possible patient care.

“Our members are treating patients through delivery models that hold them accountable for the cost and quality of the care they provide,” said AMGA President and CEO Jerry Penso, M.D., M.B.A. “These models by design do not contain the same misaligned incentives seen in the fee-for-service environment, and Medicare’s rules and policies need to recognize and account for this difference.”

AMGA recommended that CMS revise regulations and policies in the Medicare Shared Savings Program (MSSP) and waive Appropriate Use Criteria (AUC) for providers in value-based models. For example, payment waivers in the MSSP should be available for providers at all levels of risk, as restricting them based on the level of risk creates different rules that do not prepare providers for the transition into risk-bearing models. AMGA also recommended several reforms to documentation and reporting requirements. More specifically, some documentation requirements for ordering Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) do not reflect care delivery and workflow processes and should be revised.

The complete 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.