CAPG, the leading U.S. professional association for physician organizations practicing capitated, coordinated care, submitted comments at the request of the Centers for Medicare & Medicaid Services (CMS) on implementation of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). MACRA fundamentally alters the way that Medicare will pay physicians and physician groups in the future. Of primary concern to CAPG is how the Medicare Advantage program fits within the MACRA framework.
“MACRA, as currently structured, fails to afford adequate weight to risk-bearing relationships between health plans and physician groups in Medicare Advantage,” said Don Crane, CAPG’s president and CEO. “We call on the agency to take specific steps in future rulemaking to appropriately account for the role of Medicare Advantage in achieving a high quality delivery system in the future.”
In its letter, CAPG also makes recommendations relating to implementation of MACRA’s two options—the merit-based incentive payment system (MIPS) path and alternative payment model (APM) path—and on how the newly formed Physician Focused Payment Models Technical Advisory Committee should develop alternative payment models for the future.
A proposed rule implementing MACRA is expected in spring 2016; a final rule is expected later in 2016.