A new bill introduced by Representatives Suzan DelBene (D-Wash.), Peter Welch (D-Vt.), Darin LaHood (R-Ill.) and Brad Wenstrup (R-Ohio) looks to reverese Trump-era modifications to the Medicare Accountable Care Organization (ACO) program and restore higher cost savings to participating providers while removing some of the risk. The bill...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
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
The Biden administration has elected to discontinue the Next Generation Accountable Care Organization Model (Next Gen) at the end of 2021, to the disappointment of the National Association of Accountable Care Organizations (NAACOS). The program for accountable care organizations was originally expected to end at the beginning of the year...CMS Rules
The Centers for Medicare and Medicaid Services (CMS) is deep into Medicare alternative payment model (APM) revision and adjustment. One such program undergoing review is the Medicare Shared Savings Program (MSSP) and the revisions include major changes to quality reporting methodologies, the crux of the program.
CMS posted its final...National News
The Center for Medicare and Medicaid Innovation's (CMMI) new director Liz Fowler made her first public remarks this week at the National Association of Accountable Care Organizations (NAACOS) virtual conference.
We are 100% committed to expanding access to health care, and we are equally committed to continuing to move our system to...CMS Rules
The Medicare Payment Advisory Commission (MedPAC) agreed that the Department of Health and Human Services (HHS) must put together a consolidated group of alternative payment models in order to improve demonstrations.
From the commission's recommendation:
The Secretary should implement a more harmonized portfolio of fewer spending...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
Through the last few weeks in office and in anticipation of the new calendar year, the Centers for Medicare and Medicaid Services (CMS) passed a slew of rules, deadline extensions and requests for participation in order to bolster cost-lowering initiatives and incentivize participation in value-based care programs.
The federal...CMS Rules
Last week, the Center for Medicare and Medicaid Innovation (CMMI) announced the Geographic track for the Direct Contracting model. This week, the Centers for Medicare and Medicaid Services (CMS) expounded on the program, announcing that the model could be extended to Medicare Managed Care Organizations (MCOs) serving dually eligible...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...National News
On October 30, the Center for Medicare and Medicaid Innovation (CMMI) announced 51 Direct Contracting Entities (DCEs) and the implementation period for the Direct Contracting Model.
The model, called the Global and Professional Options of the Direct Contracting Model is a set of payment options which build on the idea of value-based...National News
The CMS proposal is getting mixed reactions from providers; some are expecting payment increases, others are anticipating losses and almost everyone is expecting the expansion of telehealth will be here to stay.
On Monday, August 3, the Centers for Medicare and Medicaid Services proposed the physician fee schedule (PFS), which...Arizona News
Last Wednesday, the Centers for Medicare and Medicaid Services announced a new payment model that will use upfront and capitated payments for accountable care organizations (ACOs). Called “the Community Health Access and Rural Transformation (CHART),” the Model will focus on ACOs and organizations in 15 rural communities with a...Arizona News
As the novel coronavirus wreaks havoc on global economic data, risk-bearing Accountable Care Organizations (ACOs) are worried the pandemic could threaten a decade-long shift to value-based payment models. Many facilities are struggling to stay in business as a fast-approaching May 31 deadline to give notice to the Administration in...National News
CMS published a calendar March 9 of key dates for the Medicare Direct Contracting Entity Model.
CMS' Innovation Center unveiled the Direct Contracting Entity (DCE) Model in April 2019 as part of an initiative that includes several new payment options for healthcare organizations.
Directing Contracting includes two payment model...National News
On Feb. 20, The National Association of Accountable Care Organizations (NAACOs) provided a laundry list of changes and recommendations to the Center for Medicare & Medicaid Innovation (CMMI) including ways to provide greater flexibility in the application process, increase shared savings rates for Professional Direct Contracting...White Papers, E books, Reports and more
The report's authors also estimated net savings of $755M after accounting for shared savings payments made by the Centers for Medicare & Medicaid Services (CMS).
The Washington, D.C.-based consulting firm Dobson DaVanzo & Associates was hired to produce the independent evaluation, the latest in a series, by the National...National News
The Centers for Medicare & Medicaid Services (CMS) announced that 518 ACOs are approved to participate in the newly branded Medicare MSSP, Pathways to Success program July 1; just 40 are new to the program, less than the more than 100 new ACOs the program averaged in its first seven years.
The MSSP is the largest value-based...White Papers, E books, Reports and more
This paper from Health Affairs examines the 2018 ACO contracting landscape across all payer segments to assess the extent of ACO contracts in each segment and the prevalence of ACO arrangements with downside risk. It then examines the characteristics, strategies, and perceived challenges for ACOs that have already entered two-sided risk...
