Across the country and in Arizona, hospitals both urban and rural are preparing for Medicaid cuts, which are anticipated to significantly compromise the delivery of care for safety net providers.
The One Big Beautiful Bill Act (OBBBA), signed into law on July 4, is projected to reduce federal spending on the Medicaid program by $900...
The Centers for Medicare and Medicaid Services (CMS) announced last week that it would cut four Medicare payment models, including Maryland Total Cost of Care, Primary Care First, ESRD Treatment Choices and Making Care Primary.
The models will end at the close of 2025, a year earlier than anticipated for all programs. According to...National News
The transition to value-based care has been ongoing for years. Although advances have certainly been made over the past decade, many have noticed that the switch is taking quite a while. This week, several experts and organizations weigh in on why the transition is slow, and what could speed it up.
Consistently, the leading issues...National News
The transition to value-based care (VBC) continues and the American Medical Association (AMA) and the CPT Editorial Panel published an issue brief this week on the acceleration of its adoption through the CPT code set.
As more providers transition to accountable care organizations (ACOs) and other team-based care relationships, the...Arizona News
Last summer, there were an estimated 151,500 Arizona residents aged 65 and older suffering from Alzheimer's disease, which is one in nine older Arizonans. The new CMS model promotes improved dementia care by defining and requiring a comprehensive, standardized care delivery approach that includes a standardized set of services, an...National News
The Commonwealth Fund wanted to know why nearly half of primary care physicians (PCPs) aren't joining the value-based payment (VPB) trend and how to change their minds; smaller, independent, and less-resourced PCPs serving traditional Medicare beneficiaries are the least likely to apply to VBP models, according to the issue...National News
On January 30, the Centers for Medicare and Medicaid Services (CMS) rolled out a new website that it hopes will facilitate value-based care (VBC) uptake and education.
CMS Innovation Center Director Liz Fowler has previously noted that the parameters for "value-based care" have remained elusive to industry stakeholders. In response,...National News
A bipartisan group of lawmakers have reintroduced a bill that would reform alternative payment models (APM) and allow the Centers for Medicare and Medicaid Services to extend APM incentives. Also, the agency's Innovation Center provides an update on the Accountable Care Organization (ACO) Realizing Equity, Access, and Community Health...National News
The Centers for Medicare and Medicaid Services (CMS) is requesting feedback on the design of an episode-based payment model on behalf of the Center for Medicare and Medicaid Innovation (CMMI/Innovation Center).
Episode-based payment models are designed to address inadequacies in traditional Medicare through bundling and incentive...
Last week, the Health Care Payment Learning and Action Network (LAN) published its 2022 Methodology and Results report, which is the result of a data collection survey of health plans and states for an account of how money moves through alternative payment models and how these programs function in terms of barriers and access.
In...
Last year, the Centers for Medicare and Medicaid Services (CMS) announced a roadmap for its strategic vision and priorities to expand equitable access to health coverage and promote value-based, person-centered care. The Center for Medicare and Medicaid Innovation (CMMI) illustrated its vision through five main objectives to guide its...National News
This week, the Medicare Payment Advisory Commission (MedPAC), the independent legislative branch agency tasked with analyzing the Medicare program for the purpose of offering insight and advice into the program for policymakers, published its annual Data Book.
The MedPAC Data Book, "Health Care Spending in the Medicare Program," is a...National News
At this time two years ago, the future of alternative payment models (APMs) and accountable care organizations (ACOs) was uncertain and to some degree the entire landscape of value-based care hung in the balance while the Trump administration sorted out the details of the Direct Contracting payment models. But now, under the Biden...National News
After a long wait, the Centers for Medicare and Medicaid Innovation (CMMI) announced that it has provisionally accepted 128 participants for the Participation Year 2023 cohort of the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) model. The ACO REACH model is the redesign of the Global and...CMS Rules
Earlier this year, President Joe Biden relaunched his Cancer Moonshot Initiative, which was initially established under the Obama administration to accelerate research into cancer prevention and cures. As part of the initiative, the Biden administration announced a new alternative payment model (APM) from the Center for Medicare and...National News
This week in value-based care, a fresh look at untangling VBC for providers looking to enter into an ACO or payment model, results from the Comprehensive ESRD Care Model, and some market moves in long-term and home healthcare.
A new study published in Health Affairs on Monday demonstrates that the first Medicare accountable care...National News
Value-based care is now a ubiquitous term across the medical industry, primarily led by Medicare payment models that prioritize quality of care above overall cost. But some are questioning the concept's utility and expanse over the Medicare market.
Legislation proposed in both the U.S. House of Representatives and Senate would...
More than a dozen pages cover what you need to know about Advanced Payment Models (APMs) including Accountable Care Organizations (ACOs), Direct Contracting Entities (DCEs) and Value-based Networks (VBNs) competing for Primary Care Physicians (PCPs) and beneficiaries in Arizona. Taking risk for the quality and cost of care is making...
This week in value-based care (VBC), the Biden Administration is making headway on its goal to reform alternative payment models (APMs) for the Medicare program to boost program savings and advance the administration's goal of health equity in medicine.
MIPS
To get a refresh on value-based care models including the Quality Payment...
The success of Medicare Advantage (MA) can't be understated. In the last 11 years, the program has grown to represent nearly 50% of the Medicare-eligible market, a benchmark it will likely pass within the next year.
Arizona MA growth reflects the program's national success. At the Hertel Report's 2020 Winter State of the State, Dan...
