11 health groups call on HHS to qualify Medicare Advantage providers for APM

Eleven health groups penned a letter to the director of the Center for Medicare and Medicaid Innovation arguing that HHS should recognize physician participation in Medicare Advantage as a qualifier for the Quality Payment Program's Advanced Alternative Payment Model, according to AJMC.

In the letter, the groups claim that while physician groups have to reach a 25 percent revenue threshold in traditional Medicare to qualify for the Advanced APM track under the Medicare Access and CHIP Reauthorization Act, physicians operating in areas with large Medicare Advantage populations are unable reach this threshold. The groups argue even though they are taking on risk, they do not qualify for an Advanced APM track, and are therefore calling on HHS to treat risk contracts the same for Medicare and Medicare Advantage providers.

"If we are truly committed to moving our nation's delivery system away from volume-based compensation and towards payment for value and high-quality care, we must ensure provider incentives are aligned in both traditional Medicare and MA to incent participation in risk-bearing alternative payment models," the organizations said.

The organizations called for HHS to roll out a Medicare Advantage APM using 2017 performance data for the 2019 payment year, according to AJMC.

The following organizations signed the letter:
Alliance of Community Health Plans
America's Health Insurance Plans
America's Physician Groups
BlueCross BlueShield Association
Healthcare Leadership Council
Health Care Transformation Task Force
Medical Group Management Association
National Association of ACOs
National Committee for Quality Assurance
National Coalition on Health Care
Premier

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