2016-08-17 14:23:52 UTC

AGA: Preparing Practicing GIs for the New World of Reimbursement

Aug. 23, 2016

In the ever-changing world of health care, Dr. Timothy Wang outlines the ways AGA is helping members prepare for the future.

By Timothy C. Wang, MD, AGAF
President, AGA Institute
Progress toward value-based care by Medicare and commercial payors will continue regardless of the election outcome in November. The health-care market will continue to move away from fee-for-service and toward reimbursement systems that reward physicians for improving the quality of patient care and controlling costs. 
AGA is shaping the future of practice. We continue to be at the forefront of the value-based movement, creating the tools gastroenterologists need for success in new reimbursement environments and preparing our members for a successful future. 
Did you know? 
  • AGA has created bundle and episode payment models for GI issues, including colonoscopy screening and surveillance and GERD, with obesity to launch in 2016 and more to come. These alternative payment models reward providers for identifying efficiency gains, effectively coordinating patient care and improving quality. By the time the Medicare Access and CHIP Reauthorization Act (MACRA) was enacted in 2015, AGA was ready with fully developed, practical alternative payment model solutions for GI.
  • AGA is the only GI society to advocate for Medicare to recognize established GI payment models as advanced alternative payment models (APMs) so that gastroenterologists will have a pathway to greater earnings than under the Merit-based Incentive Payment System (MIPS). Not sure what MACRA, MIPS and APMs are? AGA can help.
  • AGA is also the only GI society to develop a MACRA education tool that explains, in plain language, MACRA’s impact on GIs and offers a customized plan for how to prepare based on your practice situation.
  • AGA has established relationships with Medicare and commercial payors that allow us to provide input on coverage decisions. We recognize that payor coverage of procedures and technology plays a vital role to reimbursement success and we take every opportunity to provide payors with input from AGA member experts. 
  • In addition to AGA’s rigorous, evidence-based clinical practice guidelines, we provide expert reviews and other clinical practice guidance documents to provide best practice advice for physicians in areas in which there is not yet enough literature to produce a clinical guideline. Additionally, Technology Coverage Statements provide support when working with payors on coverage and reimbursement for proven procedures, diagnostics and therapies that advance the science and practice of gastroenterology and improve care for the patients you treat.
AGA works hard for the gastroenterology field to insure that you are poised for success under new reimbursement models and will continue to do so. 

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