Ten organizations are asking HHS Secretary Tom Price to expand the options under MACRA for physicians and physician groups to include advanced alternative payment models (APMs) that are part of Medicare Advantage plans.
In a letter sent to Price on Friday, the groups, which represent both physicians and payers, called on Price to accelerate the movement from volume to value-based payment by adopting equitable incentives for physicians taking risk in Medicare Advantage (MA) contracts with health plans.
The insurance industry was not pleased that the final rule released last October that implemented the new physician payment system under the Medicare Access and CHIP Reauthorization Act (MACRA) did not allow Medicare Advantage plans to qualify as an advanced APM for several years.
The Centers for Medicare & Medicaid Services determined that MACRA will include traditional Medicare, not Medicare Advantage. But starting in 2021, Medicare Advantage plans could qualify under the All-Payer Combination Option.
The groups asked Price to speed up that timeline and give physicians and physician groups credit for the advanced APM arrangements they conduct in Medicare Advantage.
“Recognizing the advantages of alternative payment models in MA, we call on the administration to level the playing field and afford risk arrangements in MA the same credit under MACRA as risk arrangements in traditional Medicare,” the letter said.
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