AMGA Offers Improvements To MACRA Final Rule

Sees Opportunities for Track 1+, Encourages CMS to Fully Implement Quality Payment Program in 2018

AMGA recently offered recommendations to improve the Quality Payment Program (QPP), which the Centers for Medicare & Medicaid Services (CMS) is implementing in 2017 as required by the Medicare Access and CHIP Reauthorization Act (MACRA). In comments on the MACRA final rule, AMGA indicates that an Accountable Care Organization (ACO) Track 1+ offers an opportunity to equalize how federal regulations govern the Medicare Shared Savings Program (MSSP) and the Medicare Advantage (MA) programs. AMGA’s comments also stress the importance of ensuring that only 2017 is a transition year for the Merit-Based Incentive Payment System (MIPS) so that by 2018 providers who have made the significant investments in the health information technology, staff, and cultural changes needed to succeed in a risk-based reimbursement system have the opportunity to do so.

“AMGA is eager to work with the incoming administration to develop the Track 1+ model,” said Donald W. Fisher, Ph.D., CAE, AMGA’s president and chief executive officer. “The vast majority of ACO participants are excluded from the Advanced Alternative Payment models, but if done correctly, Track 1+ will serve as an on ramp for providers to move toward increased risk sharing.”

Specifically, AMGA recommends that CMS implement a Track 1+ program that addresses the disparity in how quality is handled in the MA program, as compared to the ACO program. AMGA also endorses a number of other recommendations, which were detailed in a coalition letter it signed with likeminded provider organizations. Those recommendations include ensuring:

• Track 1+ is available to all current ACO participants;
• All current ACO program and ACO demonstration participants have the ability to participate in Track 1+ in any performance year;
• Track 1+ employs regional financial benchmarking.

AMGA’s letter on the final rule also notes that AMGA members have made substantial investments in health information technology (HIT), clinical practice improvement activities, including care coordination and better integration of behavioral and mental health services, and are participating in various pay for performance models. The transition year that CMS finalized slows the Congress and the administration’s stated goal of moving to value in health care reimbursement. AMGA strongly encourages CMS to fully implement the QPP in 2018.

“We understand that not everyone is ready for risk,” Fisher added. “And AMGA appreciates why CMS took the action it did. But moving forward, we hope that CMS continues to pursue its value agenda.”

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, and empower our members to deliver the next level of high performance health. AMGA is the national voice promoting awareness of medical groups’ recognized excellence in the delivery of coordinated, high-quality, cost-effective care. More than 170,000 physicians practice in our member organizations, delivering care to one in three Americans. For more information, visit amga.org.