AMA proactively advocates for flexibility in MACRA implementation. Both commercial and government payers have committed to transition to "Value-Based Payment" with an emphasis on quality and cost outcomes. It is critical that these changes are sustainable and adopted based on rigorous research and evidence of outcomes.
Goals for payment reform
The AMA has been working for several years to encourage the development and implementation of better Medicare payment models that will:
- Give physicians more resources and greater flexibility to deliver appropriate care to their patients than they have today
- Improve the financial viability of physician practices in all specialties, and help independent practices of all sizes remain independent
- Minimize physician administrative burdens that do not improve the quality of patient care
- Enable physicians to help control aspects of health care spending that they can influence, rather than having Medicare use inappropriate mechanisms to control costs such as payment cuts, prior authorization and/or non-coverage of services
- Avoid transferring inappropriate financial risk to physicians or jeopardizing the quality of patient care
Efforts to support physician-designed alternative payment models
Since the passage of MACRA, the AMA has been accelerating its efforts to help specialty societies and other physician organizations develop, refine and implement APMs that will achieve these goals. Physicians in each specialty should have at least one APM in which they could feasibly participate.
We believe strongly that for APMs to improve care for patients and be feasible for physicians to implement, physicians must take a proactive role in defining APMs.
Physician payment and delivery models
Review tools and resources for assessing and choosing payment models.
AMA-RAND study on the effects of health care payment models on physician practice in the United States
AMA partnered with the RAND Corporation in 2015 to conduct the first research on the impact of new payment models on individual physician practices.
AMA's efforts on MACRA implementation
MACRA correspondence and testimony
- CY 2018 Updates to the Quality Payment Program (CMS-5522-P) (PDF)
- MACRA, MIPS and APMs - June 24, 2016 (PDF)
- MACRA, MIPS and APMs - June 27, 2016 (PDF)
- Proposed Review Process for Physician-Focused Payment Model Technical Advisory Committee (PDF)
- MACRA: Examining Physician Efforts to Prepare for Medicare Payment Reforms (PDF)
- MACRA Episode Groups RFI (PDF)
- MACRA Quality Measure Development Plan (PDF)
- MACRA, MIPS and APMs - Nov. 17, 2015 (PDF)
- MACRA, MIPS and APMs - Nov. 16, 2015 (PDF)
- Supporting MACRA - April 13, 2015 (PDF)
- Supporting MACRA - March 25, 2015 (PDF)
AMA advocacy on new payment models
New payment models correspondence and testimony
- Medicare Program: Advancing Care Coordination Through EPMs; CR Incentive Payment Model; and Changes to the CJR Model (PDF)
- Medicare Program: Part B Drug Payment Model (PDF)
- Bundled Payment Program for Total Joint Replacement Surgery (PDF)
- Advanced Primary Care Model Concepts (PDF)
- Medicare Shared Savings Program (MSSP); Accountable Care Organizations (ACOs) (PDF)
- Response to MSSP; ACOs; Proposed Rule (PDF)
Table of Contents
- Goals for payment reform
- Efforts to support physician-designed alternative payment models
- Physician payment and delivery models
- AMA-RAND study on the effects of health care payment models on physician practice in the United States
- AMA's efforts on MACRA implementation
- AMA advocacy on new payment models
