Medicare & Medicaid

Efforts to improve Medicare payment reform

3 Min Read

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.

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

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.

Review tools and resources for assessing and choosing payment models.

AMA partnered with the RAND Corporation in 2015 to conduct the first research on the impact of new payment models on individual physician practices.

MACRA correspondence and testimony

New payment models correspondence and testimony

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