Last Thursday, the Centers for Medicare and Medicaid Services (CMS) published the proposed 2023 physician fee schedule (PFS) which included an overhaul to the agency's strategies on accountable care organizations (ACOs) through the Medicare Shared Savings Program (MSSP).
In February, CMS pulled the Accountable Care Organizations...
The California pilot: an alternative payment model (APM) for Federally Qualified Health Centers (FQHCs) to swap out the traditional volume-based prospective payment system with one that emphasizes principles of value-based care. In other news, CareMax will serve as the value-based management services organization to Steward's entire...News
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...National News
This week, the Center for Medicare hinted at new value-based approaches to palliative care; health equity takes precedence in the national conversation on rural payment models; and value-based contracts are analyzed for their ability to mitigate drug costs.
The Medicare Shared Savings Program (MSSP) is now ten years old, and with it...Arizona News
The transaction also includes contingent additional payments of up to $50 million based on the future performance of Caravan, a current partner in value-based arrangements for two Arizona Accountable Care Organizations, Pathfinder Health and Summit Healthcare. Early this month, Caravan announced it was expanding its footprint in the...Arizona News
Last Tuesday, providers gathered in Washington, D.C. to advocate against the Medicare direct contracting program, arguing that it could become the end of Medicare.
Members of Physicians for a national Health Program (PNHP), which supports a single-payer healthcare system brought petitions to appeal to U.S. Department of Health and...National News
Last week, the National Association of ACOs (NAACOS) sent a letter to the Centers for Medicare and Medicaid Services (CMS) requesting leniency regarding performance benchmarks and the potential option for accountable care organizations to select pre-pandemic years as the basis for benchmark measurements. Additionally, CMS announced the...National News
Comments on the Calendar Year 2022 Payment Policies Under the Physician Fee Schedule are now closed as of September 13. Changes to Medicare Part B payment policies as well as updates to the Medicare Shared Savings Program (MSSP) and the Quality Payment Program (QPP) are included in the annual PFS rule. Providers broadly oppose Medicare...National News
The Centers for Medicare & Medicaid Services (CMS) is looking forward for the potential for alternative payment models this week, and wants to leverage the potential of value-based care to support the Biden administration's quest for health equity for marginalized communities.
CMS has spent the past several months...CMS Rules
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...National News
This week, skilled nursing facilities are finding new pathways to value-based care and the Medicare Access and CHIP Reauthorization Act (MACRA) is under review for incentives. While ACOs have been struggling, the American Medical Group Association recommended several ways to improve them in a letter to the Centers for Medicare &...National News
The Biden administration has spent the first five months in office reviewing value-based care reimbursement programs authorized by the Centers for Medicare & Medicaid Services (CMS). Skilled nursing facilities (SNFs) and hospice providers, both integral parts of the Medicare program, still await instruction or expansion of...National News
According to data from the Centers for Medicare and Medicaid Services (CMS), participation in the Medicare Shared Savings Program (MSSP) is down nearly 8%. In 2020, 517 accountable care organizations (ACOs) participated, but in 2021 only 477 will participate.
A CMS fact sheet on shared savings programs demonstrates that earned shared...CMS Rules
Across the board, providers are unhappy and vocal about the calendar year 2021 pay rule released by the Centers for Medicare and Medicaid Services (CMS) last week. Due to strict budget neutrality, the agency offset a pay increase for primary care providers by cutting payment to specialists by up to 10%.
Primary care doctors and nurses...CMS Rules
On Tuesday the Centers for Medicare and Medicaid Services (CMS) released the final rule for policy adjustments under the Physician Fee Schedule (PFS) for calendar year 2021. The rule confirmed changes to telehealth payments made during the COVID-19 pandemic, but will make cuts to specialty providers.
Last March, during the onset...National News
The Centers for Medicare and Medicaid Services alternative payment models have found immediate difficulty navigating the COVID-19 pandemic with limited resources and occasionally difficult reporting requirements, but the issues between participants in these payment models and the structures of them actually go much further back than the...Arizona News
The Centers for Medicare & Medicaid Services (CMS) is proposing further regulations on how the quality of accountable care organizations (ACOs) are assessed and reported.
A coalition of healthcare organizations including the American Medical Association, America’s Essential Hospitals and the National Associations of ACOs penned...Arizona News
Value-based care has been in the forefront of public discussion on healthcare due not only to the COVID-19 pandemic but the election and updates that CMS has recently made. This week, the focus on value-based care has centered primarily on transitioning to value-based care models and the technological possibilities to make these programs...National News
The noble experiment of value-based care is being put on hold by some providers and the path toward risk has been stop and go at the Centers for Medicare & Medicaid Services. But studies and professional opinion suggests that it is beneficial to patients and clinics alike, and therefore might be worth saving.
According to Modern...CMS Rules
Accountable care organizations (ACOs) are asking for more support from the Trump administration amid the pandemic. ACOs want more time to decide on whether to voluntarily exit the Medicare Shared Savings Program (MSSP) as coronavirus-related financial losses and balance sheet deficits pile up.
With payments tied to spending and...
