AMGA Endorses Legislation That Would Modify Regional Adjustments for ACOs, To Benefit Rural ACOs

Oct. 23, 2019
The Alexandria, Virginia-based American Medical Group Association (AMGA) on October 22 endorsed legislation aimed at improving the methodology for calculating regional adjustments MSSP ACOs

The Alexandria, Virginia-based American Medical Group Association (AMGA) on October 22 endorsed legislation aimed at improving the methodology for calculating regional adjustments for organizations participating in the Medicare Shared Services Program (MSSP).

In a press release published to its website, the association announced that “AMGA today endorsed legislation, sponsored by Sen. Catherine Cortez Masto (D-Nevada) and Sen. Pat Roberts (R-Kansas), which would improve the method the Centers for Medicare and Medicaid Services (CMS) uses to calculate the regional adjustment that factors into an Accountable Care Organization’s (ACO’s) benchmark in the Medicare Shared Savings Program (MSSP). We believe the legislation, the Rural ACO Improvement Act (S.2648), will remedy a longstanding issue regarding benchmark calculations for ACOs that have inhibited the move to value-based care.”

The press release noted that, “Currently, CMS includes all patients in a region in the calculation of fee-for-service expenditures. This approach effectively penalizes ACOs that are the most efficient providers in their market and makes it more difficult for them to earn shared savings. Removing the ACO population from the regional adjustment calculation ensures that the ACO is not competing against itself if it performs well relative to its market. AMGA believes this change will encourage ACOs to participate in the MSSP and reward them for performing well then they reduce costs and improve quality.”

And it quoted Jerry Penso, M.D., AMGA’s president and CEO, as stating that “AMGA commends Congress for its attention to this critical matter and recommends that this policy pass as soon as possible so that providers can continue to transition to value-based care. Our members are strong supporters of the Medicare Shared Savings Program, which seeks to move our delivery system to one that rewards value and outcomes,” Dr. Penso emphasized. “This important legislation will ensure that our members are not penalized for being efficient providers and offer them a realistic opportunity to earn shared savings, while continuing to improve patient outcomes.”

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