Medical trade association makes value-based care recommendations to CMS

An association representing more than 450 multispecialty medical groups and integrated delivery systems is urging CMS to implement policies to advance the shift from fee-for-service to value-based care.

AMGA said the recommendations are aimed at reducing Medicare programs' regulatory complexity to ensure support for providers as they deliver care in value-based models.

"AMGA believes regulations should be designed and implemented so that providers are encouraged to innovate. Value-based models, such as accountable care organizations and other alternative payment models, are designed to remove the misaligned financial incentives that grew out of the FFS [fee-for-service] system, while also entrusting providers with the responsibility for the health of not just individual patients, but an assigned patient population," AMGA President and CEO Jerry Penso, MD, wrote in a letter to CMS Administrator Seema Verma.

"The regulatory framework governing these models of care delivery should reflect this key difference," added Dr. Penso.

His organization recommended that the federal government synchronize regulations and policies for accountable care organizations participating in the Medicare Shared Savings Program and lift the appropriate use criteria requirement for providers who order advanced diagnostic imaging in a value-based model.

AMGA argued that payment waivers should be available for all risk levels in the Medicare Shared Savings Program and that CMS should examine documentation requirements for ordering durable medical equipment, prosthetics, orthotics and supplies, "as they do not reflect care delivery and workflow processes."

The association's letter and recommendations were in response to the federal government's request for input on reducing administrative burden.

Read the full letter here.


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