Accountable Care Organizations Offer Lessons for Cardiac Bundled Payment Demonstration
Newswise — ALEXANDRIA, VA – AMGA today submitted comments on the Centers for Medicare & Medicaid Services’ (CMS) proposed Cardiac Rehabilitation and Incentive Payment Model rule. Given the mandatory nature of the program, AMGA is interested in its success and offered comments on calculating discounted target prices, measuring quality performance, risk adjustment, and evaluating the demonstration.
“The key to succeeding in episode-based payments is care integration and coordination,” said AMGA President and Chief Executive Officer Donald W. Fisher, Ph.D., CAE. “AMGA members are very experienced in these areas, and we therefore think Accountable Care Organizations (ACOs) should have the opportunity to take the lead in these bundled payment arrangements for their assigned beneficiaries.”
“Based on our members’ ACO program experience, we’ve recommended that CMS reconsider how the agency proposes to update episode target prices through the five-year demo period. We want to avoid a situation in which successful performance is not compromised by requiring providers to continually improve upon historical performance.
“Risk adjustment also is a crucial aspect of any bundled or episode-based model of care, particularly as the demonstration evolves to fully regional pricing. There are state examples that use beneficiary demographics to more accurately risk-adjust in their bundled payment initiatives and we believe that CMS can learn from these examples,” Fisher said.
AMGA’s comment letter is available here.
About AMGAAMGA is a trade association leading the transformation of health care in America. Representing multispecialty medical groups and integrated systems of care, we advocate, educate, and empower our members to deliver the next level of high performance health. AMGA is the national voice promoting awareness of our members’ recognized excellence in the delivery of coordinated, high-quality, high-value care. More than 170,000 physicians practice in our member organizations, delivering care to one in three Americans. For more information, visit amga.org
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