Healthcare Groups ask Price to Include MA Arrangements as Advanced APMs in MACRA | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

Healthcare Groups ask Price to Include MA Arrangements as Advanced APMs in MACRA

May 18, 2017
by Rajiv Leventhal
| Reprints

Several healthcare organizations have written a letter to Department of Health & Human Services (HHS) Secretary Tom Price, M.D., requesting that more Medicare Advantage (MA) arrangements count as MACRA advanced alternative payment models.

The letter, from NCQA (National Committee for Quality Assurance), CAPG, the Healthcare Leadership Council, and others, stated that Medicare Advantage makes up a third of the enrollment in Medicare while in some countries, Medicare Advantage makes up nearly half of all Medicare enrollees.  Arguing their case, the groups wrote, “Downstream from health plans, some physicians are paid through risk-based contracts. Other physicians are paid in fee-for-service arrangements. Despite providing a higher level of care coordination and better outcomes, in many ways MA payment is on a parallel track to traditional Medicare.”

Meanwhile, they noted that studies have revealed that alternative payment models in MA deliver care that is of higher quality and lower cost than care delivered in fee-for-service based MA. In fact, a recent publication in the American Journal of Managed Care demonstrated that patients in capitated MA had a six percent higher survival rate, and were 11 percent less likely to visit the ER and 12 percent less likely to have an inpatient admission, they said.

As such, they concluded, “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.  A physician should have equal incentives to take risk in traditional Medicare FFS as in a contract with a Medicare Advantage plan. Leveling the playing field across Medicare will result in better care for patients and more equitable opportunities for physicians.”

It should be noted that Price himself has recently called on doctors to come up with ideas for alternative payment models that would qualify under MACRA. The idea, he said last month in a committee meeting, would be for doctors across the country to offer up ideas about what payment model would work better for them—particularly clinicians in rural and underserved areas.

 

Get the latest information on Health IT and attend other valuable sessions at this two-day Summit providing healthcare leaders with educational content, insightful debate and dialogue on the future of healthcare and technology.

Learn More

Topics

News

Mayo Clinic Elects New President and CEO

Gianrico Farrugia, M.D., current vice president, Mayo Clinic, and CEO of Mayo Clinic in Florida has been elected as the president and CEO of the Mayo Clinic, headquartered in Minnesota.

Fitbit, Blue Cross Blue Shield Launch Mobile Health Partnership

San Francisco-based fitness wearable maker Fitbit continues its push into the health plan market with a new digital health deal to incorporate its fitness tracker into health and wellness programs.

ASCO Picks IBM Watson Exec to Lead CancerLinQ

The American Society of Clinical Oncology (ASCO) has named a former IBM Watson executive as the new CEO of its CancerLinQ big data platform.

CVS Health’s MinuteClinic Launches New Telehealth Offering

CVS’ MinuteClinic, the company’s retail medical clinic, is rolling out a new telehealth healthcare offering for patients with minor illnesses and injuries, skin conditions and other wellness needs.

Report: More than 3M Patient Records Breached in Second Quarter of 2018

More than 3.14 million patient records were breached in 142 disclosed health data breach incidents during a three-month span from April to June 2018, according to new data released in the Protenus Breach Barometer.

Industry Stakeholders Urge ONC to Move Forward on Information Blocking Rules

In a strongly worded letter to National Coordinator Donald Rucker, M.D., several healthcare and health IT industry groups expressed frustration with the Office of the National Coordinator for Health IT’s lack of progress in publishing information blocking regulations, as required in the 21st Century Cures Act.