Among the recommendations of a value-based care task force of the American Medical Group Association (AMGA) is that CMS should establish a total-cost-of-care model for end-of-life care.

AMGA  is a trade association representing multispecialty medical groups and integrated systems of care. More than 175,000 physicians practice in its member organizations. The task force produced policy recommendations organized around six pillars: enhancing patient engagement, improving health outcomes, protecting patient dignity at end of life, removing regulatory barriers, supporting rural and underserved providers, and ensuring the long-term sustainability of high-value care.



AMGA also proposes the launch of initiatives involving healthcare providers, community leaders, and advocates to create a supportive environment for end-of-life care discussions. These programs empower patients and families to make informed decisions about care options.

The report also suggests that CMS expand Medicare coverage for end-of-life care by adjusting fee-for-service models to better account for advanced illness planning and care coordination services. Additionally, it should build on existing models to include individuals who do not require nursing home-level care, offering broader comprehensive support for those facing serious health challenges. 

Benefits of prioritizing end-of-life care within high-value care frameworks include increased patient satisfaction, better resource management, and lower costs associated with hospitalizations and aggressive interventions.

The task force conceded there are challenges. For one, existing reimbursement models often fail to address the complexities of end-of-life care, which can lead to misaligned priorities in care delivery. To address these challenges, AMGA urges Congress and stakeholders to develop and adopt comprehensive policies that embed end-of-life care principles into high-value care models, ensuring that all patients receive the care they desire and deserve.

Patient engagement recommendations

AMGA recommends that Congress offer financial incentives to Medicare patients for healthy behaviors, such as providing modest financial incentives, such as premium reductions or rewards, for participating in preventive health activities such as exercise programs or dietary improvements. 

Another recommendation is to waive Medicare cost-sharing requirements for chronic care and chronic care management services. Removing financial barriers would increase engagement in care and improve disease management, the task force said. 

Turning to telehealth, the AMGA suggests that CMS permanently remove geographic and originating site restrictions to ensure broad, equitable access to telehealth services—especially in rural and underserved communities.

Another proposal involves reimbursing medical groups and health systems for employing digital health navigators who assist patients with technology. These navigators can help patients use telehealth platforms, understand health data, and engage with remote monitoring tools.

Still another recommendation is to standardize metrics, technology, and payment models to promote optimal outcomes. Implementing uniform quality metrics, interoperable technologies, and consistent payment structures enables healthcare systems to better measure performance, enhance care coordination, and incentivize high-value care, the AMGA says.