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Posts tagged with "APMs"

APMs in Limbo, MIPS Deadline Extensions and Exemptions Update National News

APMs in Limbo, MIPS Deadline Extensions and Exemptions Update

The Centers for Medicare and Medicaid Services (CMS) has posted notice and a fact sheet for Quality Payment Program (QPP) exemptions notifying providers that the deadline for data submission has been pushed back from March 31 to April 14. The extension does not apply to certain opt-in eligible groups or to Alternative Payment Model...
National News

Senate Finance Committee Explores Options to Reform Medicare Physician Pay

This week, Senate Finance Committee Chair Ron Wyden (D-Ore.) and ranking Republican Mike Crapo (Idaho) released a white paper requesting public input on the Medicare physician payment system, signaling that reform could be included in the year-end healthcare package that is expected to include permanent telehealth expansion. The paper...
National News

New ACO Primary Care Flex Model - Focus: Health Equity & Health Disparities

Open to low-revenue accountable care organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP), the CMS Innovation Center will test the five-year voluntary new model focused on primary care delivery starting in 2025. The goals of the ACO PC Flex Model are to: Expand access to high-quality, accountable care...
Open

2023 Summer State of the State Conference SOLD OUT

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White Papers, E books, Reports and more

Special Publication: The National Academy of Medicine's Recommendations for CMMI APMs

The National Academy of Medicine (NAM), an independent organization that serves as a national adviser on health and medicine with the National Academy of Sciences and the National Academy of Engineering, released a Special Publication on the lessons learned and path forward for the Center for Medicare and Medicaid Innovation (CMMI) and...
MedPAC Report Wants to Streamline APMs Even Further and Reduce MA Overspending National News

MedPAC Report Wants to Streamline APMs Even Further and Reduce MA Overspending

Last Wednesday, the Medicare Payment Advisory Commission (MedPAC) published its biennial report to Congress which included recommendations to streamline alternative payment models (APMs) within the Medicare program. It also recommended a strategy to improve accuracy in Medicare Advantage (MA) payments and correct a major contributor to...
ACO VBN Data Edition May 2022 Data Resources

ACO VBN Data Edition May 2022

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...
CMS Rules

CMS Releases 2022 Physician Fee Schedule Proposal

The Centers for Medicare & Medicaid Services (CMS) released its proposal for the 2022 Physician Fee Schedule and Quality Payment Program rules with a focus on addressing health disparities in vulnerable communities. Significantly, the fee schedule proposes a 3.75% cut in reimbursements to physicians in order to maintain budget...
CMS Rules

CMS Makes Further Edits to Enable Allowances Under Stark Law

The Centers for Medicare & Medicaid Services (CMS) have recently taken steps to correct Stark Law, and released an advisory this week that applies to physician groups providing services through wholly owned subsidiary practices that are separately enrolled in Medicare. The federal physician self-referral law, popularly known...
National News

2019 Quality Payment Program (QPP) Performance Results

The maximum MIPS payment adjustment for exceptional performance is the highest ever while participation is nearly at 100% with more than half a million clinicians participating and about 85% of small practices. Clinicians with a final score equal to or above 75.00 points will receive a positive payment adjustment in 2021 of up to...
National News

America's Physician Group Starts Up Task Force to Develop APMs

The America's Physician Group (APG) recently launched a new initiative aimed at developing advanced alternative payment models (APMs). Dubbed "the Risk Evaluation Task Force," its inception was a result of a learning collaborative looking to move volume to value. There is no lack of interest in APMs in the physician world, but...
National News

Industry Collective Advocates Recognizing Medicare Advantage as an Advanced Alternative Payment Model

A collection of provider associations is urging CMS to qualify Medicare Advantage insurers as advanced Alternative Payment Models (APMs) under the Medicare Access and CHIP Reauthorization Act (MACRA). Ten provider associations have added their voices to the call for the government to modify regulations to count Medicare Advantage to...
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