Advocacy

Hard at Work for Our Members

As a national organization with California roots, America’s Physician Groups is hard at work in Sacramento and Washington, D.C., fighting on behalf of our members—as well as the patients and communities they serve—for a healthcare system that recognizes the value of risk-based, coordinated, and accountable care.

2018 Priorities

At APG, we are tackling several priorities on our advocacy front.

The Third Option

We are pressing for a new model in original Medicare providing for direct, globally capitated contracts between the Centers for Medicare & Medicaid Services (CMS) and capable, qualifying physician groups like our members. This option expands physicians’ access to advanced alternative payment models (APMs).

Strengthening and Protecting MACRA

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is central to the goal of moving away from our current fee-for-service reimbursement system. America’s Physician Groups works with our members, CMS and Congress to provide important education to a wide variety of clinicians at various stages of value-based care.

Promoting Parity between traditional Medicare and Medicare Advantage

Our members recognize the importance of the care coordination tools Medicare Advantage provides both to clinicians and patients. APG successfully works with clinicians, associations, beneficiary groups, health plans, the Administration and Congress to improve MA funding and to strengthen the program.

Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)

MACRA, bipartisan legislation signed into law on April 16, 2015, repeals the Sustainable Growth Rate (SGR) and puts into place the Quality Payment Program (QPP) to reward Medicare clinicians for value over volume.

The QPP has two tracks: the Merit-based Incentive Payments System (MIPS) and advanced alternative payment models (APMs). APG is committed to full implementation of MACRA as intended by Congress and is educating our members and others on how to participate and be most successful.

Learn more about MACRA

APG Federal Comment Letters

Our Resources are available for Members. If you are an APG Member, please sign in to view all of our Resources.

Proposed and Final Rules and Regulations

Medicare Advantage 2019 Final Rate Notice and Call Letter (click here to access the final rate notice and call letter)
Medicare Advantage 2019 Part I Advance Notice – Risk Adjustment (click here to access the advance notice and draft call letter, Part I)
Medicare Advantage 2019 Part II Advance Notice – Risk Adjustment (click here to access the advance notice and draft call letter, Part II)
MACRA Final Rule 2018 | Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2018; Medicare Shared Savings Program Requirements; and Medicare Diabetes Prevention Program (click here to access full text published in the Federal Register)
Fee Schedule Final Rule 2018 | Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2018; Medicare Shared Savings Program Requirements; and Medicare Diabetes Prevention Program (click here to access full text published in the Federal Register)

Agency and Stakeholder Resources

CMS 2018 Open Enrollment Period Final Report
Office of Inspector General (OIG) 2017 report on the MACRA QPP
MMA Medicaid Dashboard, an online tool that tracks national and state level data, local program details, statistics, and public polling on Medicaid
OIG Report on 428 Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs) Spending and Quality
APM Framework, a white paper from the HHS Health Care Payment Learning & Action Network (LAN) to track progress toward payment reform
CMS Issuer County Map of projected participation on the Health Insurance Exchanges in 2018
MedPAC 2017 Data Book, information on national health care and Medicare spending
Medicare 2017 Trustees Report

Individual Advocacy Membership: APG Advocates

In today’s tumultuous health policy climate, it is more important than ever to have strong, unyielding support for advancing risk-based, coordinated care.

The APG Advocates program gathers like-minded individuals who are passionate about getting involved in the legislative and political process to help move our nation’s healthcare delivery system in the right direction. We know (and Congress, the administration, health policy shapers, and industry stakeholders all agree) that accountable, coordinated care delivers higher-quality, lower-cost health care. Join us! Become an APG Advocate member today. For more information contact APG Director of Federal Affairs, Margaret Peterson

Apply to join APG Advocates