Federal Advocacy

Representing our members in Washington, D.C.

APG is a national association representing over 300 physician organizations. Our members participate in pay-for-performance programs across all payer types. Moreover, many APG members have successfully operated under full risk-based models for over two decades and have developed the neccessary infrastructure and expertise to be successful in advanced risk bearing models across a wide variety of socioeconomic and geographic areas. It is our mission to proliferate our model of accountable, coordinated care across the nation. 

Federal Advocacy Priorities

Launch of the Third Option

Decades of experience show that coordinated care holds the promise of high quality, low cost healthcare delivery for patients. Currently Medicare beneficiaries are presented with two choices for Medicare participation: traditional Medicare and Medicare Advantage (MA). Neither existing model is perfectly designed to achieve the high quality, low cost healthcare our seniors deserve, and our nation's fiscal situation requires. There is an emerging consensus that additional, innovative models are necesary to improve the current delivery system to better control heatlhcare spending and improve care for America's Medicare beneficiaries. 

Consistent with this, APG believes that another option is needed. Thus, we developed a new model that builds on the best aspects of both traditional Medicare and MA called the "Third Option" which is based on our extensive experience with capitated, coordinated care. The Third Option respresents the next evolution of delivery models and addresses the flaws of existing models by incorporating sensible elements already proven to be successful in other contexts. 

Please click here for an executive summary of APG's Third Option. 

Strengthening and Protecting MACRA

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is central to the goal of moving away from our current fee-for-service reimbursement system toward a system that reimburses clinicians based on quality, efficiency, and patient outcomes. APG is calling for timely MACRA implementation, with greater access to participation in both the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs) for a wide variety of clinicians at various stages of the transformation journey. 

Central to this goal is: 

• The expansion of additional Advanced APMs including APG's Third Option
  
• Improved participation in MIPS by lowering the low volume threshold
  
• Increased integration of MA and Medicaid into MACRA beyond the "other payer" option
  
• Partnerships between CMS, Congress, and healthcare stakeholders to improve quality metrics and data sharing in current value-based models including the Medicare Shared Savings Program (MSSP)