A collection of provider associations is urging CMS to qualify Medicare Advantage insurers as advanced Alternative Payment Models (APMs) under the Medicare Access and CHIP Reauthorization Act (MACRA).
Ten provider associations have added their voices to the call for the government to modify regulations to count Medicare Advantage to qualify under the as early as 2019.
The letter’s authors:
- Premier Healthcare Alliance
- American College of Surgeons
- American Medical Association
- American Medical Group Association
- American Osteopathic Association
- America’s Essential Hospitals
- Healthcare Leadership Council
- Healthcare Transformation Task Force
- Medical Group Management Association
- National Association of ACOs
From the authors:
We urge CMS to alter its regulations to allow clinicians’ contracts with MA 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
Under MACRA, eligible professionals who meet minimum revenue thresholds from certain APMs or minimum numbers of beneficiaries in APMs are eligible for a 5 percent bonus payment. Under current regulations, CMS restricts the bonus to Medicare fee-for-service (FFS) revenue and patients.
“Providers with risk-based Medicare Advantage contracts are meeting the requirements to qualify as advanced APMs, and they should be recognized for transitioning the health system to value sooner rather than later. We believe this proposal allows CMS to reward providers who are willing to take risk,” wrote Chester A. Speed, J.D., LL.M., AMGA’s vice president of public policy.
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