In a comment letter submitted to the Centers for Medicare & Medicaid Services (CMS), America’s Physician Groups (APG) applauded the Agency for its work to help strengthen and protect Medicare Advantage (MA) on behalf of the millions of beneficiaries it serves while also noting specific areas of concern with the recently released MA 2020 Advance Notice and Call Letter.
“MA it is a critical component in transforming our nation’s healthcare system from volume to value-based,” said Don Crane, APG president and CEO. “Numerous studies show that despite a higher proportion of clinical and social risk factors, MA beneficiaries have better health outcomes than their peers in traditional Medicare. A strong rate notice is central to supporting this important program and improving our nation’s healthcare system overall.”
APG applauded the Agency’s work to expand supplemental benefits in MA and better address the opioid crisis through certain targeted services and cost-sharing reductions, but expressed concern with the rate adjustment itself, issues related to MA benchmarking, and the implementation of the transition from the Risk Adjustment Processing System (RAPS) to the Encounter Data System (EDS).
The letter closes by highlighting APG’s support for policies in MA which incent plans and providers to participate in risk-bearing models and called for CMS to extend the 5 percent advanced alternative payment bonus to qualified MA providers as a standalone threshold.
“The 5 percent bonus will level the playing field between providers taking risk in MA and those in traditional Medicare,” said Crane. “This will allow greater opportunities and incentives for risk-contracting in MA and will advance the Medicare delivery system for all seniors.”
Please click here for a copy of APG’s comment letter.