AMGA calls for CMS to streamline MA, MSSP and Medicare FFS

The American Medical Group Association penned a letter to CMS Monday calling for it to "synchronize" Medicare Advantage with the Medicare Shared Savings Program and Medicare fee-for-service.

"Doing so would create a more spending efficient Medicare program in sum, reduce the substantial burden providers and patients presently face in understanding and navigating different regulatory rules for three programs and would mitigate the burden taxpayers currently face in financing an under-performing and spending inefficient Medicare program," AMGA Vice President of Public Policy Chester Speed wrote in a letter addressed to CMS Administrator Seema Verma.

The letter was a response to a CMS call for recommendations on how to improve Medicare Advantage and Part D.

As the three Medicare programs currently operate distinctly in terms of beneficiary assignment, coverage, financial incentives, payment rules and quality measures, they create undue administrative burden for providers, the letter states. They also offer different benefits, premiums, co-pays and deductibles for enrollees.

AMGA argues if payment rules and incentives for the three types of Medicare programs were more similar, the programs could compete amongst each other, eliminating inefficiencies and giving consumers better options while reducing Medicare spending.

"Beyond transforming the Medicare program by substantially increasing beneficiary spending efficiency and dramatically reducing provider administrative burden, synchronizing premiums would likely qualify MA providers to participate in the MACRA alternative payment model pathway," Mr. Speed wrote.

AMGA also voiced support for incentive-neutral policies across the three programs due to the insufficient evidence across ACOs, bundled payment participants and the physician quality reporting system that physicians have been able to successfully generate results. "Few would disagree the evidence in support of financially incenting providers is, at best, mixed," Mr. Speed wrote. Instead, AMGA supports intrinsic motivation baked into policy and quality improvement programs.

Read the full letter here.


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