National Physician Organization Responds to Newly Proposed Medicare Payment Rule

CAPG Calls for Specific Changes that Would Lead to Better Patient Outcomes

LOS ANGELES--()--CAPG, the nation’s leading organization for risk-bearing physician groups, sent a letter Monday to Andy Slavitt, Acting Administrator for the Centers for Medicare & Medicaid Services, commenting on CMS’s proposed rule regarding traditional Medicare payments to providers. The proposed rule would expand on the agency’s mandatory bundled payment programs.

“bundles should remain a transitional model…Bundles should represent a first step in this direction, not a destination for delivery system reform.”

In the letter, CAPG President and CEO Donald Crane states: “CAPG is encouraged by the agency’s continued commitment to the goals of moving traditional Medicare payments from fee-for-service to value-based payment models.”

But Crane believes that physicians taking risk under Medicare Advantage aren’t getting equal treatment under the agency’s proposals. He argues that “while MACRA incentives will be afforded to physicians who take a comparatively small amount of risk in a mandatory bundled payment arrangement in traditional Medicare, MACRA as currently proposed ignores physicians who pursue full capitation in Medicare Advantage. We think these incentives are misaligned, inequitable and require immediate adjustment.”

Another area of concern is with the role of bundled payment models in the delivery system reform landscape. CAPG supports the proposed bonus for bundles but calls for parity in treatment of physician risk-bearing across the entire Medicare program. Crane cautions that “bundles should remain a transitional model…Bundles should represent a first step in this direction, not a destination for delivery system reform.”

About CAPG

CAPG is the nation’s leading association for and the voice of physician organizations practicing capitated, coordinated care. Its membership comprises approximately 250 multispecialty medical groups and independent practice associations (IPAs) across 41 states, the District of Columbia, and Puerto Rico. CAPG members strongly believe that comprehensive, accountable, risk-based coordinated care provides the highest quality, most efficient delivery, and greatest value for patients. Our members have successfully operated under this budget-responsible model for more than two decades. For more information, please visit http://capg.org.

Contacts

CAPG
Daryn Kobata, 213-239-5045
dkobata@capg.org