Center for Medicare and Medicaid Innovation

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 [...]

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 [...]

Federal Health Policy Update for Thursday, September 9

The following is the latest health policy news from the federal government as of 2:30 p.m. on Thursday, September 9.  Some of the language used below is taken directly from government documents. The White House The White House has issued a fact sheet outlining how the administration plans to improve the country’s readiness for future pandemics.  The major elements of the plan are transforming medical defenses, ensuring situational awareness, strengthening public health systems, building core capabilities, and managing the mission. The White House has posted a transcript of the September 2 press briefing given by its COVID-19 response team and [...]

Health Policy Update for Thursday, August 19

The following is the latest health policy news from the federal government as of 2:30 p.m. on Thursday, August 19.  Some of the language used below is taken directly from government documents. The White House The White House has issued a fact sheet highlighting the latest administration actions to address COVID-19.  Those actions include its plan to begin offering COVID-19 booster vaccines starting the week of September 20; a soon-to-be-published regulation requiring workers in long-term-care facilities to be vaccinated (described below); a directive to the Secretary of Education to use all available tools to ensure that governors and other officials [...]

Federal Health Policy Update for Thursday, August 5

The following is the latest health policy news from the federal government as of 2:45 p.m. on Thursday, August 5.  Some of the language used below is taken directly from government documents. Final Medicare Inpatient Prospective Payment System Regulation for FY 2022 CMS has published its final Medicare inpatient prospective payment system regulation for FY 2022.  Highlights include: An increase in hospital inpatient rates of 2.5 percent and an increase in long-term hospital rates averaging 0.9 percent. The Medicare disproportionate share (Medicare DSH) payments uncompensated care allocation has been cut $1.1 billion, to $7.2 billion, with distribution to be based [...]

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 [...]

Federal Health Policy Update for Friday, July 9

The following is the latest health policy news from the federal government as of 2:45 p.m. on Friday, July 9.  Some of the language used below is taken directly from government documents. White House President Biden has issued an executive order “…to promote competition in the American economy, which will lower prices for families, increase wages for workers, and promote innovation and even faster economic growth.”  Among other things, the executive order calls for closer scrutiny of corporate consolidation, maintaining that such consolidation results in a “…lack of competition [that] drives up prices for consumers.  As fewer large players have [...]

Federal Health Policy Update for Monday, June 28

The following is the latest health policy news from the federal government as of 2:30 p.m. on Monday, June 28.  Some of the language used below is taken directly from government documents. Supreme Court Decision in Affordable Care Act Case The Supreme Court has declined to hear an appeal of a case in which insurers unsuccessfully sued to recover reductions in their Affordable Care Act federal cost-sharing reduction payments. White House The White House has posted a transcript of the June 22 press briefing given by its COVID-19 response team and public health officials. Department of Health and Human Services [...]

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 [...]

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 [...]

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