AGA encourages CMS to include GI specialty APMs under MACRA: 5 notes

Representatives from the American Gastroenterological Association recently met with CMS officials to advocate for the expansion of alternative payment models under MACRA.

Here's what you need to know:

1. Larry Kosinski, MD, and Joel V. Brill, MD, met with officials from CMS and the Center for Medicare and Medicaid Innovation.

2. Drs. Kosinski and Brill noted that the current criteria to qualify as an advanced APM would not allow most specialty models to qualify.

3. Dr. Brill discussed AGA's bundle and episode payment models for GI issues. He said that gastroenterology practices that participate in these models should be able to qualify as APMs.

4. Dr. Kosinski discussed Project Sonar, a medical home he founded in conjunction with Blue Cross and Blue Shield of Illinois. Project Sonar, which uses AGA's inflammatory bowel disease quality measures, has seen a reduction in emergency department visits, inpatient hospitalizations and costs of care.

5. The two physicians told CMS that GI payment models that demonstrate the results seen in Project Sonar should be recognized as clinical practice improvement activities, and should represent a path to APM qualification.

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