APG Rebuts Arguments Against Medicare Advantage and Direct Contracting Models

Washington, DC – In a letter to HHS Secretary Xavier Becerra today, America’s Physician Groups (APG) responded to inaccurate criticisms from Drs. Donald Berwick and Rick Gilfillan about the Medicare Advantage (MA) program and the Centers for Medicare and Medicaid Innovation (CMMI) Global and Direct Contracting (GPDC) pilot programs.

“While APG has great respect for Drs. Berwick and Gilfillan, our members feel quite strongly that some of their arguments against MA and the direct contracting models are simply inaccurate,” said Don Crane, APG President and CEO. “While we agree with many of the observations by Drs. Berwick and Gilfillan, many of their recommendations will produce the unintended effect of thwarting our achievement of the Triple Aim which we all support.”

APG is a national association of physician-focused healthcare organizations that are patient-centered and focused on achieving the best healthcare outcomes possible. APG members successfully utilize MA and accountable care organizations (ACO) to provide better, accountable care for patients and help reduce health disparities in underserved communities.

Drs. Berwick and Gilfillan argue that the GPDC model will bring the same MA payment dynamics to Medicare fee-for-service which will hurt ACOs by forcing primary care providers to choose between staying with their ACO or joining a direct contracting entity (DCE). APG believes that direct contracting is the next iteration of the ACO framework and will help deliver better value to patients through care coordination across multiple settings.

GPDC provides an invaluable opportunity to study the impact that a capitated payment system can have on primary care, and allows primary care providers to care for underserved communities that suffer from the consequences of health inequities.

Click here to read the full letter here.

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About America’s Physician Groups
America’s Physician Groups is a national association representing more than 335 physician groups with approximately 170,000 physicians providing care to nearly 90  million patients. APG’s tagline, ‘Taking Responsibility for America’s Health,’ represents our members’ vision to move from the antiquated, dysfunctional fee-for-service reimbursement system to a clinically integrated, value-based healthcare system where physician groups are accountable for the coordination, cost, and quality of patient care. Visit us at www.apg.org.

Contact: Greg Phillips, APG Director of Communications, 202-770-1901, gphillips@apg.org