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...
In late February, the Centers for Medicare and Medicaid Services (CMS) announced that after a full year of review, it would overhaul the Global Professional Direct Contracting Model and create the Accountable Care Organization (ACO) Realizing Equity, Access and Community Health (REACH) model. The redesign was intended to address...
It has been nearly a year since the Biden administration's Center for Medicare and Medicaid Innovation (CMMI) placed the Medicare Direct Contracting model (DC) under review. The Centers for Medicare and Medicaid Services (CMS) said last week that a decision on the alternative payment model (APM) would come "soon," leaving investors and...
Value-based payment arrangements are rapidly growing with several Arizona-based companies either joining national programs or expanding value-based design to other areas of the country. The National Association of Accountable Care Organizations (NAACOS) says that bigger changes can't come fast enough.
In a press release last week,...National News
The Direct Contracting payment model, devised under President Donald Trump's Center for Medicare and Medicaid Innovation (CMMI), grows more controversial as it has ended up in the crosshairs of Congressional progressives. But some Democrats and industry advocates support the payment model remaining on the table.
Early this month, more...National News
The COVID-19 pandemic has revealed the necessity for immediate changes to the healthcare system at large and placed value-based care, the model that rewards providers for better patient outcomes, at the center of that discussion. This week, the discussion extends to population health, interoperability, and preventative...Arizona News
The Next Generation accountable care organization (Next Gen ACO) alternative payment model will end in 2022, but not before it saved Medicare some significant money, according to new data from the Centers for Medicare and Medicaid Services (CMS). CMS found that in 2020, the Next Gen model saved $637 million on the whole, but that number...