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APMs: Getting it Right across Payers

Much of the attention around the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) has focused on the overhaul of Medicare’s fee-for-service payment system. Equally, if not more, transformative is the provision of MACRA that seeks to incent alternative payment methodologies (APMs) across payers starting in 2021. As leaders in value-driven APMs, Medicaid Directors believe this provision offers the opportunity to synchronize our work and more effectively transform our health system.

This week NAMD offered initial insight on this new incentive program, which CMS is in the early stages of designing. We underscore that success can be maximized by building unique Medicaid issues into the design of the multi-payer program – for instance, ensuring the model reflects the variation between Medicaid programs and state APMs. We also point out opportunities for CMS to align its work internally and with its federal partners to drive widespread transformation through this initiative. In particular, we urge our federal partners to ensure adequate support is available to support the state design and implementation of APMs.

NAMD’s letter on the MACRA multi-payer incentive program is available on our website. In addition, NAMD’s 4th Annual Operations Survey provides additional information on Medicaid’s unique role in innovation, as well as key capacity challenges Directors face in carrying out this work.

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