WASHINGTON, DC — Multiple changes adopted today by the Centers for Medicare & Medicaid Services bode well for physician groups and the nation’s ongoing transition to value-based health care, according to America’s Physician Groups (APG), the largest organization of physicians committed to being held accountable for the costs and quality of health care. Of special note are steps to invigorate the Medicare Shared Savings Program (MSSP), the signature accountable care organization (ACO) model created under the Affordable Care Act.
“We’re very pleased to see the many changes in store for the Medicare Shared Savings Program, which will only increase the odds that more health care providers will participate in the program,” said APG President and CEO Susan Dentzer. “Clearly CMS has listened closely to physicians with long experience in ACOs in making these changes.”
The positive changes in the rule include the following:
The adoption of Medicare Clinical Quality Measures (CQMs) as an alternative collection type for MSSP ACOs, and the fact that the data completeness requirement will be 75 percent rather than 80 percent.
The delay until 2025 of the implementation of the Merit-Based Incentive Payment System (MIPS) Promoting Interoperability performance category.
The aligning of application of the risk adjustment methodology for the performance years and the benchmark years.
The new add-on payment for HCPCS code G2211, which will better recognize the resource costs associated with evaluation and management visits for primary care and the longitudinal care of complex patients.
The new stand-alone G code, G0136, for administration of a standardized, evidence-based Social Determinants of Health Risk Assessment, incorporated into MSSP beneficiary assignment and other methodologies.
The retention of the current practice of APM Entity-level QP determinations.
“APG’s key concern is the impact of the payment cut in Medicare physician fees inherent in the new rule,” Dentzer said. At $32.74, the so-called conversion factor for 2024 — the dollar multiplier used to convert adjusted relative value units into payment amounts for physician services — will now be $1.15, or 3.4 percent, below the conversion factor for 2023. As a result, “Medicare physician fees will continue to fall even as inflation and practice expenses climb, and many physicians continue to leave the practice of medicine,” Dentzer added. “The situation is unsustainable, and we look forward to working with Congress and other policymakers to redress these fee cuts soon.”
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About America’s Physician Groups
America’s Physician Groups is a national association representing approximately 360 physician groups with 170,000 physicians providing care to nearly 90 million patients. APG’s motto, ‘Taking Responsibility for America’s Health,’ represents our members’ commitment to clinically integrated, coordinated, value-based health care in which physician groups are accountable for the costs and quality of patient care. Visit us at www.apg.org
Contact: Greg Phillips, APG Director of Communications, 202-770-1901, firstname.lastname@example.org