While Washington’s focus has been on the congressional effort to repeal the Affordable Care Act (ACA),
AMGA is working with the senior administration officials to reduce the regulatory burden facing physicians
and advance our value-based care agenda.
AMGA is working with the senior
administration of;cials to reduce the
regulatory burden facing physicians
and advance our value-based care
Our discussions with senior officials at the Department of Health and Human Services (HHS) and the
Centers for Medicare & Medicaid Services (CMS) indicate that our regulatory priorities are aligned with HHS
Secretary Tom Price’s goals. In consultation with our
membership, AMGA has developed key policy goals
that are intended to reform Medicare’s requirements so
doctors can dedicate their energies and talents toward
providing the best possible patient care, rather than
divert their attention toward regulatory compliance
activities that do not improve the patient experience.
Reducing Physician Burden
Sec. Price publicly has addressed the need to reduce
the burden on physicians and ensure that Medicare’s
rules and regulations do not interfere with the doctor-
patient relationship. This priority dovetails with
AMGA’s key regulatory goal of advancing the shift of
the reimbursement system to one based on value.
For those practitioners and groups that assume
financial risk, AMGA believes that the regulatory
structure needs to be kept to a minimum and provide
as much flexibility as possible. In value-based models,
such as Accountable Care Organizations (ACOs) or
other Alternative Payment Models (APMs), the incentives and goals are to provide the best possible care, in
the most clinically appropriate setting, while also driving down costs. Given that these models are based on
achieving the Triple Aim—improving the experience of
care, improving the health of populations, and reducing
per capita costs of health care—a number of the regulations governing how doctors provide care are at best
superfluous and at worst counterproductive, as they
have little to no influence on the care being provided.
AMGA is encouraging HHS and CMS to waive or
reduce the rules on these providers as much as possible
and in a number of key areas.
The law and regulations governing physician
self-referral, commonly known as the Stark law, was
intended to prevent potential conflicts of interest from
influencing physician decision making. Unfortunately,
the interpretations of this law can pose a significant
regulatory obstacle to practicing medicine. Despite
increased integration and financial relationships, as
well as innovative care delivery models, providers face
a rigid regulatory framework with disproportionate
penalties for noncompliance.
BY DARRYL M. DREVNA