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David Introcaso

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Change in CMS primary-care program seen scaring away some providers

For integrating MA plans with ACOs

Healthcare research and policy consultant David Introcaso argues in a HealthAffairs post that  Medicare Advantage plans  should be included in the federal government’s goal to transition Medicare to a value-based payment system.

Part of the explanation for MA plans’ exclusion so far might be that the Centers for Medicare and Medicaid Services  doesn’t know enough about how MA plans reward physicians for quality and value.

In any event,  he says, excluding MA plans from the government’s goal ignores “substantial and rapidly growing” MA spending.  Mr. Introcaso notes that  MA is expected to have more than 25 million enrollees  by 2024, meaning that  about 30 percent of all Medicare payments would be left out of the government’s value-based initiative if the regulations aren’t changed.

He argues for  integrating alternative-payment models — especially Accountable Care Organizations (ACOs) —  with MA plans, although that would require some major regulatory adjustments.



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