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February 27, 2019
AMGA Supports CMS Medicare Advantage Plan for Supplemental Benefits
Endorses Flexibility in Addressing Chronic Disease
Alexandria, VA – AMGA today recommended that Medicare Advantage (MA) plans and their provider partners have the flexibility to identify patients who would benefit from an expansion of supplemental benefits. In comments submitted today to the Centers for Medicare & Medicaid Services (CMS) on its proposal for the 2020 Medicare Advantage plan year, AMGA emphasized that as many patients as possible should benefit from new benefit offerings. Authorized as part of the AMGA-endorsed Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017, MA plans may broaden the type of supplemental benefits that are available to Medicare beneficiaries with chronic illness. In determining specific illnesses beneficiaries must have to qualify for the benefits, AMGA recommended that CMS provided as much flexibility as possible, rather than adopt a prescriptive list of what conditions or diseases qualify.
“Medicare Advantage is an increasingly attractive model for AMGA members because it offers a framework that fosters care coordination and innovations in care delivery,” said AMGA President and CEO Jerry Penso, M.D., M.B.A. “By adopting an expansive approach as to who qualifies for special benefits, CMS will help providers and plans focus on treating chronic disease by looking at the patients’ needs, particularly those social needs that are so important to wellbeing.”
AMGA’s letter to CMS also addressed the importance of accurate risk adjustment and largely endorsed CMS’ proposal to account for both the number and severity of conditions in the CMS Hierarchical Condition Category model.
The complete letter is available on the AMGA website.
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