MACRA and Value-Based Care Task Force Recommendations

As the U.S. healthcare system stands at a pivotal juncture, the imperative to reassess and refine the future of healthcare financing to support modern care delivery and practices has never been more pressing. Central to this evolution are group practices and integrated systems ofcare, which are uniquely positioned to lead the transformation toward a more coordinated, efficient, and patient-centered model. These organizations have demonstrated the capacity to deliver high-quality care while managing costs, making them essential players in the journey toward value-based care (high-value care).

Recognizing the approaching 10-year anniversary of the Medicare Access and CHIP Reauthorization Act (MACRA), AMGA established the MACRA and Value-Based Care Task Force in 2023 to build on the successes of the law, while also recognizing the potential for improvements. This initiative responds to congressional inquiries about ensuring that Medicare appropriately reimburses professional services under Part B and enhances the viability and sustainability of high-value care. The Task Force comprises members from some of the nation’s leading multispecialty group practices and integrated care systems, all committed to transforming healthcare delivery in the United States.

The Task Force began itswork by identifying policies and regulations within the Medicare reimbursement system that hinder the ability of AMGA members to provide optimal care. While MACRA aimed to shift Medicare from a fee-for-service model to one that rewards value, its execution has revealed challenges. These include complexities in the Merit-Based Incentive Payment System (MIPS), limited participation in Advanced Alternative Payment Models (APMs), and the need for more robust support for small, rural, and underserved practices.Informed by their experiences delivering care under MACRA’s reimbursement and regulatory framework, the Task Force examined all aspects of the care delivery reimbursement model.

The Task Force’s policy made recommendations for each pillar, aiming to guid
e policymakers in reauthorizing
 MACRA and shaping a simple and sustainable healthcare system that supports the ability of AMGA members to deliver high-value care. By removing regulatory and statutory barriers and enabling patients to engage with their provider teams on their treatment plans and goals, the Task Force’s recommendations are designed to meet the needs of all patients across the country, regardless of location and income, by reforming Medicare’s reimbursement system. By focusing on the strengthsof group practices and integrated care systems, we can pave the way for a future in which high-quality, patient-centered care is accessible to all.