Alternative payment models

Federal Health Policy Update for Monday, November 15

The following is the latest health policy news from the federal government as of 2:45 p.m. on Monday, November 15. Some of the language used below is taken directly from government documents. The White House The White House has posted a transcript of the November 10 press briefing given by its COVID-19 response team and public officials. Go here for the slides presented during that briefing. Centers for Medicare & Medicaid Services – Final Guidance on Shared/Co-Located Hospital Spaces In a memo to state survey agencies, CMS has published final guidance for the evaluation of compliance with the Medicare Conditions [...]

iqtsupport2021-11-15T17:19:23-05:00November 15, 2021|Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Coronavirus, COVID-19, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare reimbursement policy|

Federal Health Policy Update for Thursday, November 4

The following is the latest health policy news from the federal government as of 2:45 p.m. on Thursday, November 4. Some of the language used below is taken directly from government documents. New Federal Vaccination Requirements CMS has unveiled its new COVID-19 vaccine requirements for health care providers that receive reimbursement from the federal government. The highlights include: CMS is requiring COVID-19 vaccination of eligible staff at health care facilities that participate in the Medicare and Medicaid programs. The staff vaccination requirement applies to the following Medicare and Medicaid-certified provider and supplier types: ambulatory surgery centers, community mental health centers, [...]

iqtsupport2021-11-04T17:17:11-04:00November 4, 2021|340b, Alternative payment models, Centers for Medicare & Medicaid Services, Congress, Coronavirus, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid upper-payment limit, Medicare post-acute care, Medicare regulations, MedPAC, Telehealth|

Innovation Center Unveils Blueprint

The CMS Innovation Center has published a document that shares its strategic direction for the coming years. Driving Health System Transformation – A Strategy for the CMS Innovation Center’s Second Decade reviews the lessons the agency has learned over the past ten years and lays out its objectives for the next ten: Drive Accountable Care – increase the number of people in a care relationship for quality and total cost of care. Advance Health Equity – embed health equity in every aspect of CMS Innovation Center models and increase focus on underserved populations. Support Care Innovation – leverage a range [...]

iqtsupport2021-10-21T13:00:01-04:00October 21, 2021|Alternative payment models, Center for Medicare and Medicaid Innovation, CMMI|

CMS Funds Expanded Telehealth in Four States

The Centers for Medicare & Medicaid Services is building on its Community Health Access and Rural Transformation (CHART) Model by awarding up to $20 million to organizations in four states to expand the use of telehealth in their communities and introduce other improvements that enhance access to care in rural areas. Organizations in Alabama, South Dakota, Texas, and Washington state will receive $2 million for planning and up to $3 million each for achieving specific objectives. The CHART model seeks to use telehealth and other means, reimbursed through an accountable care organization model, to address health disparities and reduce hospital [...]

iqtsupport2021-10-21T06:00:15-04:00October 21, 2021|Accountable Care Organization, ACO, Alternative payment models, Telehealth|

Changes Coming in Innovation Center Payment Models

Future Medicare payment models will probably feature less risk for participants and a greater emphasis on health equity. At least that is the vision shared by Centers for Medicare & Medicaid Services chief operating officer Jon Blum during a recent conference. While not backing away from including risk in future value-based purchasing models, CMS and the Center for Medicare and Medicaid Innovation Center will probably propose fewer full-risk models, which the agency fears favor wealthier providers that can afford to shoulder more risk to begin with, and a greater focus on reporting race and ethnicity data among future model participants [...]

iqtsupport2021-10-05T06:00:24-04:00October 5, 2021|Alternative payment models, Center for Medicare and Medicaid Innovation, CMMI|

Federal Health Policy Update for Monday, August 30

The following is the latest health policy news from the federal government as of 2:30 p.m. on Monday, August 30. Some of the language used below is taken directly from government documents. Temporary Suspension of COVID-19 Data Reporting Requirements for Some Hospitals The Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response has announced that federal hospital COVID-19 reporting requirements for the entire state of Louisiana and parts of Mississippi have been suspended for seven days in response to Hurricane Ida. While hospitals in the affected areas may still report their data if they [...]

iqtsupport2021-08-30T18:45:57-04:00August 30, 2021|Accountable Care Organization, ACO, Alternative payment models, Centers for Medicare & Medicaid Services, Coronavirus, COVID-19, MACPAC, Medicaid and CHIP Payment and Access Commission, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for Thursday, July 22

The following is the latest health policy news from the federal government as of 2:45 p.m. on Thursday, July 22. Some of the language used below is taken directly from government documents. White House The White House has posted a transcript of the July 22 press briefing given by its COVID-19 response team and public health officials. Centers for Medicare & Medicaid Services Health Policy News CMS has published its proposed calendar year 2022 Medicare outpatient prospective payment system regulation. Among other subjects, the proposed regulation addresses hospital outpatient and ambulatory surgery center payment rates, hospital price transparency, the section 340B [...]

iqtsupport2021-07-22T17:21:47-04:00July 22, 2021|340b, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Coronavirus, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare regulations, Medicare reimbursement policy|

New Health Care Leaders Share Priorities

New leaders at the Centers for Medicare & Medicaid Services and the Center for Medicare and Medicaid Innovation are quickly making their priorities known to health care industry stakeholders. For new CMS administrator Chiquita Brooks-LaSure, her priority is coverage. She has declared that “Our focus is going to be on making sure regulations and policies are going to be focused on improving coverage,” and while she hopes that states that have not yet expanded their Medicaid programs will take advantage of current federal incentives to do so, there is another path to coverage: “…the public option or other coverage certainly [...]

iqtsupport2021-06-10T06:00:44-04:00June 10, 2021|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, Medicaid|

CMS Reconsidering Medicare Payment Models

Five Medicare alternative payment models previously slated for implementation are being delayed, cancelled, or reconsidered. The five APMs whose futures are not clear are: The Community Health Access and Rural Transformation Model ACO Track Primary Care First Kidney Care Choices Geographic Direct Contracting Part D Payment Modernization Model Learn more about the Centers for Medicare & Medicaid Services’ latest actions on these models in the Becker’s Hospital Review article “5 CMS payment models that are under review, delayed.”

iqtsupport2021-04-26T06:00:47-04:00April 26, 2021|ACO, Alternative payment models, Centers for Medicare & Medicaid Services, Medicare, Medicare reimbursement policy|

MedPAC Meets

The Medicare Payment Advisory Commission met in Washington, D.C. last week to discuss various Medicare payment issues. Among the issues discussed at MedPAC’s April meeting were: Medicare skilled nursing facility value-based purchased program. Medicare alternative payment models (APMs). Medicare Advantage benchmark policy. Medicare indirect medical education (Medicare IME) payments. Medicare vaccine coverage and payments. Medicare payment for prescription drugs prescribed on an outpatient basis. Private equity and Medicare. Medicare clinical laboratory fee schedule. MedPAC is an independent congressional agency that advises Congress on issues involving Medicare. While its recommendations are not binding on either Congress or the administration, MedPAC is [...]

iqtsupport2021-04-07T06:00:07-04:00April 7, 2021|Alternative payment models, Center for Medicare and Medicaid Innovation, CMMI, Medicare regulations, Medicare reimbursement policy, MedPAC|