Alternative payment models

Federal Health Policy Update for October 5

The following is the latest health policy news from the federal government for September 29 to October 5. Some of the language used below is taken directly from government documents. Congress Last Saturday, Congress passed a 45-day continuing resolution (CR) to fund the federal government through November 17. Part of that limited CR includes a delay of the scheduled $8 billion cut to Medicaid DSH allotments to states through the end of the CR. The bill also extends funding for community health centers and the National Health Services Corps for the same length of time. Congress will have to act [...]

admin2023-10-05T14:53:32+00:00October 5, 2023|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, COVID-19, health equity, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for September 21

The following is the latest health policy news from the federal government for September 15 - 21. Some of the language used below is taken directly from government documents. Congress With only nine days left in the current federal fiscal year, Congress still has not agreed on any kind of spending bill to keep the federal government operating past September 30. If the federal government shuts down, the Department of Health and Human Services (HHS) will “use the full extent of the authority under the Antideficiency Act (ADA) to maintain existing HHS activities…” In previous shutdowns, Medicare has continued to [...]

admin2023-09-21T15:37:11+00:00September 21, 2023|Alternative payment models, Congress, COVID-19, Medicaid, Medicare, Medicare reimbursement policy|

Federal Health Policy Update for August 24

The following is the latest health policy news from the federal government for August 11-24. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services After suspending the No Surprises Act-created Independent Dispute Resolution process in the wake of a court ruling striking down a recent increase in fees for that process, CMS has established a new rate structure for initiating the adjudication of payment disagreements between providers and payers. It explains the new rate structure in this new FAQ, which nevertheless notes that despite the creation of new rates, the Independent [...]

Federal Health Policy Update for August 10

The following is the latest health policy news from the federal government for August 4-10. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has temporarily suspended the federal Independent Dispute Resolution process, which adjudicates problems involving surprise medical bills, in the wake of a federal court ruling that found some of the process’s underlying regulations invalid. CMS has directed the certified Independent Dispute Resolution entities to pause all dispute resolution activities. As a result, providers and insurers temporarily cannot initiate new disputes. Learn more from this CMS notice. CMS [...]

admin2023-08-10T16:32:27+00:00August 10, 2023|Alternative payment models, Centers for Medicare & Medicaid Services, COVID-19, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare reimbursement policy, MedPAC, Telehealth|

Federal Health Policy Update for August 3

The following is the latest health policy news from the federal government for July 29-August 3. Some of the language used below is taken directly from government documents. Medicare Payment Regulations CMS has issued a final rule updating Medicare payment policies and rates for inpatient and long-term-care hospital services under its inpatient prospective payment system and long-term care prospective payment system for FY 2024. The final rule increases hospital inpatient rates 3.1 percent and LTCH rates 3.3 percent in FY 2024. Other highlights include a nearly $1 billion cut in Medicare disproportionate share (Medicare DSH) and Medicare DSH uncompensated care [...]

admin2023-08-03T15:28:05+00:00August 3, 2023|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, health equity, Medicaid, Medicare, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for July 20

The following is the latest health policy news from the federal government for March 13-16. Some of the language used below is taken directly from government documents. Congress Senator Bernie Sanders (I-VT), chair of the Senate Health, Education, Labor and Pensions (HELP) Committee, has introduced a bill, the “Primary Care and Health Workforce Expansion Act.” The bill would: Increase funding for community health centers by $65 billion over five years, fund the National Health Service Corps at $8.3 billion over five years, and provide $250 million for HRSA coordination for the Women, Infants, and Children (WIC) program. Add 10,000 graduate [...]

admin2023-07-20T16:54:58+00:00July 20, 2023|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, Congress, COVID-19, health equity, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare regulations, Medicare reimbursement policy|

Inadequate Data Hinders Federal Approach to Health Equity

Federal efforts to develop and improve payment models and other programs designed to foster health equity are often hamstrung by poor data: inconsistent data requests from program to program and flawed and incomplete data reporting by those participating in those programs. As a result, federal policymakers often are unable to tell whether programs – both those developed specifically to address health equity and those that are not – are having the desired effect on health equity. The result, according to a new study from the Centers for Medicare & Medicaid Services’ Center for Medicare and Medicaid Innovation, is that 1) [...]

admin2023-07-19T10:50:34+00:00July 19, 2023|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, health equity|

Federal Health Policy Update for June 29

The following is the latest health policy news from the federal government for June 23-29. Some of the language used below is taken directly from government documents. The White House President Biden has issued an executive order on strengthening access to affordable contraception and family planning services for women with private health insurance and through Medicaid, Medicare, and federally supported health programs and to foster research on access. Learn more from this White House fact sheet and the administration’s executive order. Department of Health and Human Services HHS’s Office of the Inspector General (OIG) has posted its final rule [...]

admin2023-06-29T15:36:39+00:00June 29, 2023|Affordable Care Act, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare reimbursement policy|

Federal Health Policy Update for April 7

The following is the latest health policy news from the federal government for March 31 – April 7. Some of the language used below is taken directly from government documents. The White House President Biden has signed an executive order calling for the modernization of the regulatory review process. Among other objectives, the order seeks to improve the effectiveness of the regulatory review process and promote inclusive regulatory policy and public participation. The order gives the Office of Management and Budget, through its Office of Information and Regulatory Affairs and in consultation with the Council of Economic Advisers and representatives [...]

admin2023-04-07T17:07:33+00:00April 7, 2023|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, health equity, Medicaid, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, social determinants of health|

Federal Health Policy Update for March 30

The following is the latest health policy news from the federal government for March 24-30. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS’s Center for Medicare and Medicaid Innovation (CMMI) has extended its Medicare Advantage Value-Based Insurance Design (VBID) Model for calendar years 2025 through 2030 and will introduce changes intended to address more fully the health-related social needs of patients, advance health equity, and improve care for patients with serious illness. Learn more from this CMS announcement, which includes a link to additional information about the program. CMS [...]

admin2023-03-30T17:20:37+00:00March 30, 2023|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare reimbursement policy, Telehealth|