AMGA joins provider groups urging CMS to include Medicare Advantage in advanced APM models

AMGA and numerous other provider stakeholders penned a letter to CMS, calling on the agency to include eligible Medicare Advantage contracts in the Medicare Access and CHIP Reauthorization Act's advanced alternative payment models.

In the May 31 letter, the organizations said MACRA's Quality Payment Program allows eligible professionals "who meet or exceed minimum revenue thresholds coming from Advanced APMs or minimum numbers of Medicare beneficiaries in Advanced APMs" to potentially receive a 5 percent bonus on Medicare payments annually from 2019 through 2024. But AMGA in a news release notes CMS restricts the bonus to only Medicare fee-for-service revenue and patients, excluding Medicare Advantage arrangements until the 2021 payment adjustment year. The letter calls on CMS to change regulations "to allow clinicians' contracts with Medicare Advantage plans that meet the risk, quality and certified electronic health information technology requirements to be included under the beneficiary count test for the 5 percent Advanced APM bonus in 2019 and 2020."

"Congress provided a framework with MACRA to move toward a system that is based on value," Chester Speed, AMGA's vice president of public policy, said in the release. "This proposal builds on that effort and illustrates the opportunity that CMS has to increase APM participation by recognizing how participating in qualified Medicare Advantage plans can help providers meet the challenging advanced APM eligibility requirements."

In addition to AMGA, the letter was signed by Premier healthcare alliance, American College of Surgeons, American Medical Association, American Osteopathic Association, America's Essential Hospitals, Healthcare Leadership Council, Healthcare Transformation Task Force, Medical Group Management Association and National Association of ACOs.

Read the full letter here.


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