AMGA Endorses Amendment Requiring Commercial Payers to Share Claims Data with Providers

Alexandria, VA - Today, AMGA endorsed an amendment to S. 1339, the Pharmacy Benefit Manager Reform Act, offered by Sen. Markwayne Mullin (R-OK), which would require commercial payers to share claims data with providers. The amendment builds upon the Centers for Medicare & Medicaid Services' (CMS’) efforts to promote data sharing to enable progress toward value-based care.

"Allowing providers to access administrative claims data from commercial payers has been a longstanding priority for AMGA and its members," said AMGA President and CEO Jerry Penso, MD, MBA. "The passage of this amendment will ensure that multispecialty medical groups and integrated delivery systems have access to this data, which provides a more comprehensive view of their patient's health, which is key to providing better care."

For the past five years, AMGA has conducted annual risk-readiness surveys of our membership to obtain a snapshot of the progress and challenges providers face during the value-based transformation of the U.S. healthcare system. In the surveys, AMGA members noted that the most significant barrier to succeeding in value-based care arrangements was a lack of access to administrative claims data. Today’s action by the Senate gets providers one step closer to being able to get a complete picture of their patients and help them deliver high-quality and cost-effective care.  

"This amendment will help providers care for their patients,” Penso added. “We urge Congress to ensure that this provision is signed into law."

AMGA’s endorsement letter is available on AMGA’s 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.