On Tuesday, Jan. 12, the leaders of the Los Angeles-based America’s Physician Groups (APG), a national association of the leaders of multispecialty physician groups participating in value-based contracting, called on the incoming Biden administration to accelerate the movement to value, strengthen the Medicare Advantage program to drive better value, and work to lower healthcare costs.
A press release posted to APG’s website on Tuesday morning began with this statement: “America’s Physician Groups (APG) congratulates President-Elect Joe Biden, Vice President-Elect Kamala Harris, and his transition team on his election to the Presidency of the United States. In a letter to President-Elect Biden, APG recommends three key strategies to help his administration improve the quality of and access to our nation’s healthcare services: Accelerating budget-based prospective payment models, strengthening the Medicare Advantage program, and lowering healthcare costs through drug pricing reform and encouraging more at-home and ambulatory patient care.”
The press release quoted Don Crane, the association’s president and CEO, as stating that “APG looks forward to working with President Biden and his administration as he focuses on improving healthcare for all Americans. To do this, we must keep driving the momentum toward value-based care by using a budget-based prospective payment model. This will create a stronger healthcare system by lowering costs and improving care. Our country’s unsustainable healthcare costs are largely due to the antiquated fee-for-service payment system,” Crane stated.
APG’s leaders focused on three key areas:
“Accelerating the Movement to Value – Value-based models of care emphasize the delivery, measurement and outcomes of care as opposed to the current fee-for-service model that focuses on volume of services at the expense of cost and what is the best for patients. Innovative healthcare providers are successfully delivering improved patient care at lower costs through budget-based prospective payment models and these models must be recognized and supported. APG notes that if the Biden Administration drafts a plan for a public healthcare option, it recommends that a budget-based prospective payment system be used for physician groups.
Strengthening Medicare Advantage (MA) to Drive Better Value – Supporting MA is integral to moving from volume to value in healthcare. Physicians and health plans who engage in high-value risk-based MA contracts and who are working hard to improve overall quality in the MA program should be rewarded for those efforts. Congress, the Centers for Medicare & Medicaid Services, and other stakeholders must work together to create incentives that further drive the evolution in MA as they do in traditional Medicare.
Lowering Healthcare Costs – Lowering the costs of care through drug pricing reform and transferring more patient care to ambulatory and home settings is a key piece of the value-based movement supported by APG. Allowing more people to receive care in their home via telehealth has increased convenience and treatment options for patients while also lowering costs and producing improved outcomes. Drug importation reform, value-based purchasing, and international pricing models are all possible solutions to address high drug prices.”
