AMGA Ready to Work with Congress and to Lead Transition to Value-Based Health Care

ALEXANDRIA, Va.–(BUSINESS WIRE)–Today AMGAdetailed its legislative agenda to the 115th Congress in a letterthat emphasized the importance of continuing the shift to value-drivenreimbursement in health care. The new Congress offers an opportunity forlawmakers to address a number of important issues in creating a pathwayto value in health care. AMGA and its membership of 450 multispecialtymedical groups and integrated delivery systems are prepared to be aresource to Congress as it addresses these priorities.

“It is very clear that policymakers want to transform how health care isfinanced and provided,” said Donald W. Fisher, Ph.D., CAE, AMGA’spresident and chief executive officer. “Our priorities are based on theneed to address the obstacles that are preventing providers fromsucceeding in a risk-based system that values and rewards qualityinstead of the volume of services provided.”

Fisher continued, “Access to standardized claims data is of vitalimportance to providers. Without it, providers cannot reasonably carefor and improve the health of a patient population.”

AMGA’s letter specifically notes several key improvements that need tobe made to fulfill the broader goal of a value-based healthcare system:

Access to claims data: Federal and commercial payers must provideaccess to all administrative claims data to healthcare providers sothey can manage a patient population.

Standardization of data: Absent a standard data submission andreporting process for all federal and commercial payers, providersface a needless administrative burden in reporting data.

Access to capital: Providers should be permitted to use income on atax-free basis to invest in the infrastructure necessary to take ondownside risk.

The letter also details key improvements that should be made to helpensure a successful implementation of the Medicare Access and CHIPReauthorization Act of 2015 (MACRA) and its new payment system, forwhich AMGA members have been diligently preparing:

Medicare Advantage revenue should be considered in payment year 2019for Advanced Alternative Payment Model (APM) purposes to providegreater opportunity to participate in these new care arrangements,which have the potential to improve population health.

The financial risk thresholds for Advanced APM status need to beadjusted to account for the possible lack of commercial risk productsin local markets.

The significant investments that Track 1 Accountable CareOrganizations make in information technology and care process redesignshould qualify them for Advanced APM status.

In addition, AMGA emphasized to Congress how vital the in-officeancillary services (IOAS) exception within the Stark physicianself-referral law is to multispecialty medical groups and integratedhealthcare delivery systems.

The letter also stressed the importance of preserving MedicareAdvantage, ensuring appropriate healthcare coverage, and strengtheninggraduate medical education.

About AMGA

AMGA isa trade association leading the transformation of health care inAmerica. Representing multispecialty medical groups and integratedsystems of care, we advocate, educate, innovate, and empower our membersto deliver the next level of high performance health. AMGA is thenational voice promoting awareness of our members’ recognized excellencein the delivery of coordinated, high-quality, high-value care. More than175,000 physicians practice in our member organizations, delivering careto one in three Americans. For more information, visit

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