MGMA urges Congress to address value-based care priorities (November 22, 2024)

November 22, 2024 
 

Re: End-of-Year Legislative Priorities to Support Value-Based Patient Care

Dear Speaker Johnson, Leader Jeffries, Leader Schumer, and Leader McConnell:

As you and your colleagues address pressing issues before the 118th Congress adjourns, the undersigned organizations encourage you to pass an end-of-year health care package that includes an extension of Medicare’s Advanced Alternative Payment Model (AAPM) incentive payments, ensures that AAPM qualifying thresholds remain attainable, and replaces a scheduled cut to Medicare’s physician payments with an update reflective of inflationary pressures.

Since the enactment of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), Medicare’s AAPM incentives have helped more than 500,000 physicians and other health care providers cover the investment costs of moving to new payment models, provided the financial resources to expand care teams, enabled adoption of population health infrastructure, and aided clinicians in providing services beyond those typically covered by traditional Medicare.

Accountable care models enable physicians, hospitals, and other health care providers to deliver high-quality, well-coordinated, cost-effective care to Medicare beneficiaries. These payment reforms have generated more than $28 billion in gross savings for Medicare over the past decade. The Centers for Medicare & Medicaid Services (CMS) recently released results showing that the Medicare Shared Savings Program and ACO REACH Model, the largest APMs in Medicare, generated $2.8 billion in net savings for the Medicare program in 2023, while improving patient access and quality. Medicare’s AAPM incentive payments have produced a good return on investment that has broad stakeholder support from physician and health care associations, health systems, provider practices, and ACOs.

Even though these positive results show the benefits that APMs bring to the health care system, ongoing support is needed to help physicians and other health care providers transition into, remain in, and succeed in these payment models. Continuing the incentives and maintaining the current qualifying thresholds beyond 2024 will help sustain and grow participation in value-based payment models and help extend the reach of APMs to new patient populations, as well as rural and underserved communities.

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