The American Medical Association (AMA) is praising a new Innovation Center voluntary initiative aimed at bringing technology-supported chronic care squarely into Original Medicare, calling it a long-needed move to remove payment barriers that prevent physicians from using digital tools shown to improve outcomes.
This week the Centers...News
A new policy brief from the influential Washington-based Paragon Health Institute warns that Congress should either reform or shut down the CMS Innovation Center, arguing the program has failed to deliver meaningful savings or quality improvements despite costing taxpayers billions. The report concludes that, after more than a decade of...Arizona News
The Centers for Medicare and Medicaid Services (CMS) will launch a pilot program for the Wasteful and Inappropriate Service Reduction (WISeR) Model, which will implement prior authorization into the traditional Medicare program. CMS has selected six states for the pilot, including Arizona.
The Hertel Report covered the model after it...Arizona News
The Cell and Gene Therapy (CGT) Access Model uses outcomes-based payment agreements designed to improve care while protecting taxpayer dollars.
Arizona is one of 33 states participating in the new, voluntary federal initiative to expand access to cutting-edge gene therapies for Medicaid patients led by the CMS Innovation Center. The...News
CMS is signaling its next chapter in value-based care; in a newly released white paper, the agency outlined its 2025 strategy and beyond, doubling down on prevention, patient engagement, and competition. CMS also announced this week upcoming changes to ACO REACH’s financial methodology based on the agency's review of REACH ACO's first...
In April, NAACOS signaled its intent to work with new CMS Administrator Mehmet Oz on the future of value-based care, as new JAMA studies this week highlighted savings from MSSP and shortcomings in the REACH ACO model. Oz also faced pressure from Congressional Republicans this week, who accused CMMI of advancing costly models that miss...
President Trump went big last week, signing an executive order packed with measures to cut prescription drug costs, targeting Medicare price negotiations, PBM broker fees, hospital outpatient drug pricing, and 340B discount enforcement, all aimed at delivering savings for American patients and taxpayers.
Several of the EO’s...
The Department of Health and Human Services is continuing its ongoing purge of federal workers, which is having major impacts on healthcare providers, payers and medical infrastructure across the country.
As many as 10,000 workers may be cut from the workforce, including some leadership positions, in positions ranging from...
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...
The Center for Healthcare Quality & Payment Reform (CHQPR) offers steps to support its contention that value-based payment is only successful when explicitly designed to support value-based care, which the CMS Innovation Center says requires increased data sharing and the AMA warns is only possible when health systems/plans and...
In November, the Centers for Medicare and Medicaid Services (CMS) announced a Notice of Funding Opportunity (NOFO) for the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model.
The AHEAD Model is intended to cut costs for states and improve overall patient health while advancing health equity, according to...
Most accountable care organizations (ACOs) participating in the final year of the Global and Professional Direct Contracting (GPDC) Model earned shared savings of while 23% reported losses in 2022. Collectively, the ACOs generated $870 million in gross savings after accounting for shared savings and losses and discounts paid, a 700%...
The Congressional Budget Office (CBO), which advises Congress on the budget and spending, published its most recent testimony on accountable care organizations (ACOs) and the Center for Medicare and Medicaid Innovation (CMMI).
As noted last week, the CBO found that CMMI was directly responsible for an increase in spending of $5.4...
The Centers for Medicare and Medicaid Services (CMS) announced the creation of a new payment model for people diagnosed with dementia.
The Guiding an Improved Dementia Experience (GUIDE) Model is an alternative payment model focused on preserving quality of life for diagnosed dementia patients while keeping them at home and providing...
Adding a seventh track to the advanced payment model would provide a better bridge from the Medicare Shared Savings Program (MSSP) to the ACO REACH model, according to the National Association of Accountable Care Organizations NAACOS. CMS is taking your comments.
According to a NAACOS blog post by David Pittman, the organization's...National News
The Center for Medicare and Medicaid Innovation (CMMI) was accused of harming access to innovative drugs during a House Ways and Means Health Subcommittee meeting last week. GOP lawmakers are taking issue on a proposed CMMI model designed to test strategies to make it easier for Medicare patients to afford and access needed prescriptions...Arizona News
This week, accountable care has a new definition following the Health Care Payment Learning and Action Network (LAN) Summit, and the Centers for Medicare and Medicaid Services (CMS) look to get more Affordable Care Act (ACA) plans into value-based insurance design.
Out with the old, in with the new. LAN received feedback from...National News
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...White Papers, E books, Reports and more
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...Arizona News
The Center for Medicare and Medicaid Innovation (Innovation Center) announced the provisional acceptance of 110 Accountable Care Organizations (ACOs) applications to the ACO REACH model. We have identified seven ACOs that made the provisional list to operate in Arizona. Four REACH ACOs are already operating in the state as part of the...
