The Centers for Medicare & Medicaid Services (CMS) should concentrate on promoting independent physician practices as it looks for ways to advance new payment models, TMA and other medical groups wrote in a letter to CMS Administrator Seema Verma.
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The letter is a response to CMS’ request for information on a new direction for the Centers for Medicare and Medicaid Innovation. It was signed by Aledade, a Maryland-based company that helps primary care physicians create tech-enabled accountable care organizations, as well as TMA, the American Academy of Family Physicians, the Medical Group Management Association, and others.
In the letter, the groups make four recommendations of how CMS can expand opportunities for physician-led practices:
- Prioritize physician-led advanced alternative payment models (AAPMs), “including two-sided, more advanced, higher-gain models calibrated to reflect the realities faced by small physician practices.” These models eventually should offer a greater reward for taking on greater risk, while providing more predictable and accurate benchmarks, the groups said.
- Take action against consolidation, such as curbing facility fees that create higher payments for the same services and prohibiting anticompetitive practices such as data blocking and noncompete requirements.
- Remove barriers to new provider-run Medicare Advantage plans, including creating a system in which physician groups could “contract directly with the agency to ‘insource’ administrative functions like claims processing and fraud/abuse detection.”
- Allow consumers to share in any savings and to “receive added benefits from their physicians and/or have their cost sharing reduced or eliminated.” However, these changes “must not impose substantial new administrative burden and paperwork requirements on already over-burdened practices,” the letter said.
“Physicians ― especially independent physician practices ― are the lynch pin of our nation’s health care system. They have repeatedly demonstrated their superior ability to generate positive results in value-based care arrangements, both in improved health outcomes and reduced costs,” the letter said. “They are the most powerful tool we have to foster an affordable, accessible system that puts patients first.”
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Last Updated On
January 02, 2018
Originally Published On
January 02, 2018