Accountable Care Organization

CMS Touts ACO REACH Model Results

An evaluation commissioned by the Center for Medicare and Medicaid Innovation has found that the agency’s Medicare ACO REACH (Realizing Equity, Access, and Community Health) Model is saving money and improving health care outcomes. A summary of an evaluation of the program’s 2023 performance year explained that The ACO REACH Model is an advanced accountable care organization (ACO) initiative to promote patient-centered care, lower costs, and align payment systems for Original Medicare beneficiaries through ACO risk-sharing and prospective payment.  In performance year (PY) 2023, the model showed stronger improvements in quality than prior years and lowered gross spending across all [...]

Federal Health Policy Update for July 16

Don’t Miss: CMS proposed 2027 physician payment regulation House Ways and Means passes health care bills DHS publishes new, final public charge rule HHS pursues delivery models for potential psychedelic drugs for behavioral health treatment The following is the latest health policy news from the federal government for July 10-16.  Some of the language used below is taken directly from government documents. CMS – Proposed 2027 Medicare Physician Fee Schedule Rule CMS has published its proposed physician fee schedule rule for 2027.  Highlights include: A proposed reduction in Medicare physician rates. A reduction of payments for evaluation and management (E/M) [...]

Federal Health Policy Update for July 2

  Don’t Miss: CMS proposes CY 2027 Medicare outpatient rates, reviving 340B cuts, expanding site-neutral payments CMS calls for modest Medicare home health pay hike, more ways to oust providers Court halts borrowing limit that jeopardized supply of qualified health professionals The following is the latest health policy news from the federal government for June 25-July 2.  Some of the language used below is taken directly from government documents. Proposed CY 2027 Medicare Outpatient Prospective Payment and Ambulatory Surgical Center Rule CMS has published its proposed Medicare FY 2027 outpatient and ambulatory surgical center prospective payment system rule.  The proposed [...]

Federal Health Policy Update for April 23

The following is the latest health policy news from the federal government for April 17-23.  Some of the language used below is taken directly from government documents. The White House President Trump has issued an executive order calling for accelerated access to medical treatments for patients with serious mental illness, with an emphasis on greater access to psychedelic drugs.  Learn more from this executive order and an accompanying White House fact sheet. Shortly after the White House issued this executive order, HHS’s Advanced Research Projects Agency for Health (ARPA-H) announced the first set of research teams for its Evidence-Based Validation [...]

Federal Health Policy Update for April 3

The following is the latest health policy news from the federal government for March 27 to April 3.  Some of the language used below is taken directly from government documents. Proposed and Final CMS Medicare Regulations Proposed FY 2027 Medicare Inpatient Rehabilitation Facilities Payment Rule CMS has published a proposed rule updating Medicare payment policies and rates for inpatient rehabilitation facilities (IRF) under its IRF prospective payment system and updating the IRF quality reporting program for FY 2027.  CMS proposes updating FY 2027 IRF rates by 2.4 percent based on a market basket update of 3.2 percent less a proposed [...]

Federal Health Policy Update for March 19

The following is the latest health policy news from the federal government for March 13-19.  Some of the language used below is taken directly from government documents. The White House President Trump has issued an executive order creating a Task Force to Eliminate Fraud that “…shall, on behalf of the President, coordinate and accelerate a comprehensive national strategy to stop fraud, waste, and abuse within Federal benefit programs, including programs administered jointly with State, local, tribal, and territorial partners.”  The vice president will chair the task force, the Secretary of the Department of Health and Human Services is among its [...]

CMS Will Continue Rolling Out Mandatory Models

The Centers for Medicare & Medicaid Services and its Center for Medicare and Medicaid Innovation intend to continue developing and introducing mandatory Medicare models with an emphasis on driving more value-based care. That is the message delivered by CMS administrator Mehmet Oz and CMMI director Abe Sutton during a recent conference. While the track record of CMMI’s models – both voluntary and mandatory – is not great, policymakers believe they remain the best way for government to continue encouraging health care providers to focus more on the delivery of value-based care.  To date, only four of the agency’s approximately 50 [...]

Federal Health Policy Update for February 19

The following is the latest health policy news from the federal government for February 13-19.  Some of the language used below is taken directly from government documents. Congress Congress is not in session this week and will return on Monday, February 23. The House Ways and Means Committee will hold a hearing titled “Next Generation of Health Care Workforce” on Tuesday, February 24.  View a livestream of the hearing here. The Courts A federal court has vacated the Federal Trade Commission’s (FTC) 2024 overhaul of the Hart-Scott-Rodino Premerger Notification Rule.  That rule expanded disclosure requirements, requiring filings for transactions valued [...]

Federal Health Policy Update for February 5

The following is the latest health policy news from the federal government for January 30 through February 5.  Some of the language used below is taken directly from government documents. Congress On Tuesday Congress passed, and the president immediately signed, a package of appropriations bills that, among other government operations, funded the Department of Health and Human Services for the rest of federal FY 2026.  Major provisions include: The extension of telehealth flexibilities through the end of 2027. The elimination of $8 billion cuts in Medicaid disproportionate share (Medicaid DSH) allotments to the states for both FY 2026 and FY [...]

Federal Health Policy Update for December 18

The following is the latest health policy news from the federal government for December 12-18.  Some of the language used below is taken directly from government documents. Congress In a 216-211 vote yesterday, the House passed the Lower Health Care Premiums for All Americans Act, a Republican package aimed at addressing multiple health care policies.  The legislation includes provisions for employee tax-advantaged benefits like HSAs and FSAs, cost-sharing reductions (CSR) subsidies, and increased transparency requirements for pharmacy benefit managers (PBMs).  It notably did not include an extension of the enhanced Affordable Care Act premium tax credits that many of the [...]

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