Alternative payment models

CMS Revamps Medicare ACO Program

The federal government seeks to pursue greater savings and an accelerated approach to value-based care through an overhaul of its programs for Medicare accountable care organizations. The Centers for Medicare & Medicaid Services’ new “Pathways to Success” program seeks to speed up the process of providers assuming risk for costs and outcomes through the following changes from the agency’s current approach. A reduction in how long participating ACOs can remain in the program without assuming some responsibility for their spending. Modifications that CMS hopes will encourage physician groups to remain independent of hospitals and health systems. Greater flexibility to innovate [...]

iqtsupport2018-12-31T06:00:14-05:00December 31, 2018|Accountable Care Organization, ACO, Alternative payment models, Centers for Medicare & Medicaid Services, Medicare regulations, Medicare reimbursement policy|

APM Use Rising

Alternative payment models now account for more than one-third of health care payments, according to a new analysis. Leading the way is Medicare Advantage plans, which expend nearly half of their Medicare payments through APMs. Learn more about this trend in health care delivery and payments in the report “APM Measurement: Progress of Alternative Payment Models,” which was prepared by the Health Care Payment Learning & Action Network and can be found here.

iqtsupport2018-10-26T06:00:53-04:00October 26, 2018|Alternative payment models|

Medicaid APMs Moving in New Directions

For the most part, states’ use of alternative payment models in their Medicaid programs so far have focused on the work done by primary and acute-care providers. Now, a number of states are starting to extend their use of APMs in other areas, including: behavioral health providers safety-net providers long-term care providers For a look at what states are doing to drive value in Medicaid payments in these new areas, see the Commonwealth Fund article “The Next Generation of Paying for Value in Medicaid,” which can be found here.

iqtsupport2018-10-18T06:00:25-04:00October 18, 2018|Alternative payment models, Medicaid|