AMGA Objects to Medicare Advantage Rate Cuts
AMGA today objected to the Centers for Medicare & Medicaid Services (CMS) cut in the finalized 2025 benchmark rate for Medicare Advantage (MA) plans. AMGA is concerned the cut in the benchmark payments by 0.16% does not account for the increased cost of providing care and the increase in utilization.
2025 Rate Announcement Adds to Providers’ Financial Uncertainty
Alexandria, VA – AMGA today objected to the Centers for Medicare & Medicaid Services (CMS) cut in the finalized 2025 benchmark rate for Medicare Advantage (MA) plans. AMGA is concerned the cut in the benchmark payments by 0.16% does not account for the increased cost of providing care and the increase in utilization.
“AMGA providers will have to absorb yet another round of payment reductions, first on the fee-for-service side with a cut in the conversion factor and now in Medicare Advantage,” said AMGA President and CEO Jerry Penso, MD, MBA. “While the MA benchmark rate is directed at the payer community, these cuts will affect how AMGA members are reimbursed for caring for MA beneficiaries. I’m concerned plans will reduce their benefit packages to account for this cut, which will be detrimental to patients and providers.”
AMGA also remains concerned about the continued phase-in of changes to the MA risk adjustment model, which ultimately will result in lower payments to MA and providers.
AMGA strongly supports CMS’ continued work on its Universal Foundations measure set, which will create a core set of measures that are aligned across programs. CMS is working to include all of the Universal Foundation measures into the Part C and Part D Ratings, pending future rulemaking. This effort largely matches AMGA’s work from 2018, when our Board of Directors endorsed a streamlined set of quality measures. This measure set was designed to simplify the reporting process and limit the burden on providers and group practices, while still reporting clinically relevant and actionable data. AMGA would be pleased to continue to work with CMS on this effort.
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About AMGA
AMGA is a trade association leading the transformation of healthcare in America. Representing multispecialty medical groups and integrated systems of care, we advocate, educate, innovate, and empower our members to deliver the next level of high performance health. AMGA is the national voice promoting awareness of our members’ recognized excellence in the delivery of coordinated, high-quality, high-value care. More than 175,000 physicians practice in our member organizations, delivering care to one in three Americans.
AMGA represents medical groups and integrated systems of care. Its diverse membership includes multispecialty medical groups, integrated delivery systems, accountable care organizations, and other entities committed to improving healthcare outcomes. AMGA advocates for the formation of innovative, clinically integrated systems of care that advance population health, enhance patient experience, and reduce healthcare costs. For more information, please visit www.amga.org.