2017-02-01 16:18:56 UTC

AGA Supports Physician-Focused Payment Models

Feb. 1, 2017

AGA is committed to preparing GIs for success in new reimbursement environments.

AGA has long been a leader in the development of episodes of care and value-based care models, even before the Medicare Access and CHIP Reauthorization Act (MACRA) was passed. Our commitment to gastroenterologists’ success in new reimbursement environments led to the creation of a number of AGA alternative payment models that reward providers for identifying efficiency gains, effectively coordinating patient care and improving quality. 

As part of our commitment, AGA recently provided feedback on two Physician-Focused Payment Model (PFPM) proposals submitted to the Physician-Focused Payment Model Technical Advisory Committee, which reviews PFPMs, prepares comments and recommendations regarding whether such models meet certain criteria, and submits comments and recommendations to HHS. 

Alternative payment models (APMs) typically include a single payment for a condition or treatment and cover a pre-defined set of services across multiple providers and multiple settings. 

If approved, the proposed PFPMs may be implemented in the future as APMs that GIs would be able to use to meet requirements of the CMS Quality Payment Program. However, the timeline for implementation is uncertain and any proposal currently under consideration that is ultimately approved as an APM may not be implemented before 2018.

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