At a time when many physician practices are frustrated over the lack of advanced alternative payment models (APMs), America’s Physician Groups hopes to be part of the solution.
The professional association for accountable physician groups yesterday announced the launch of a new task force to help develop future advanced APMs. The Risk Evaluation Task Force was formed as a learning collaborative to accelerate the volume to value movement and support the development of the next generation of advanced APMs, said the group, which is composed of over 300 medical groups and independent practice associations.
Physician practices interested in participating in an advanced APM have been thwarted by the fact that Medicare does not offer enough of the payment models that are clinically relevant to their practice. But there’s no lack of interest. The first new advanced APM launched under the Trump administration drew nearly 1,300 providers, including 715 physician group practices, who signed up to participate in the first wave of the Centers for Medicare & Medicaid Services’ (CMS) voluntary bundled payment program.
Participating in an advanced APM is one of two tracks under the value-based physician Medicare payment program created under MACRA.
“Data tells an important story—integrated, risk-bearing delivery systems outperform fragmented, fee-for-service systems in both cost and quality,” Don Crane, APG President and CEO, said in an announcement. “But this story is more than that; it’s about providing access to high quality, affordable healthcare services to all Americans. And our new Task Force provides members with the education and support they need to improve the nation’s healthcare system by putting providers on a budget and holding them accountable for patient outcomes.”
The task force will focus on two goals: educating and sharing best practices among APG members and advocacy aimed at key members of Congress and officials at the Department of Health and Human Services and CMS.
The task force will be co-chaired by two APG members experienced in risk bearing contracting, Melanie Matthews, CEO of Physicians of Southwest Washington, and Niyum Gandhi, executive vice president and chief population health officer of the Mount Sinai Health System.
Two national experts will assist the task force with data analytics and care transition planning. They are Aneesh Chopra, president of Care Journey and former U.S. Chief Technology Officer, and Eric Coleman, M.D., founder of The Care Transitions Program and professor of medicine and head of the division of health care policy and research at the University of Colorado Anschutz Medical Campus.
Chopra and his team will provide ACO-level benchmarks defined by the task force. Coleman will work to improve care transitions with the aim of reducing hospital and emergency department admissions and re-admissions, which are one of the most impactful levers for succeeding in risk contracting.
A recent poll of over 400 group practices by the Medical Group Management Association found only 11% said an advanced APM is available to them. However, 44% said their practice would be interested in participating in an advanced APM if it was clinically relevant and aligned with the medical group’s quality goals.