Medicare APMs

MedPAC Meets

MedPAC’s commissioners held their latest public meetings on Thursday, November 7 and Friday, November 8. The subjects on the meetings’ agenda were: reforming physician fee schedule updates and improving the accuracy of payments considering the participation bonus for clinicians in advanced alternative payment models structural differences between the prescription drug plan and Medicare Advantage prescription drug plan markets assessing Medicare Advantage provider networks Medicare’s coverage limits on stays in freestanding inpatient psychiatric facilities Go here for summaries of the issues and key points and links to the presentations delivered by MedPAC staff and find a transcript of the two-day session [...]

joe2024-11-14T16:54:24-05:00November 18, 2024|Alternative payment models, hospitals, Medicare, Medicare reimbursement policy, MedPAC|

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|

Too Many Medicare APMs?

MedPAC thinks maybe that’s the case. At the recent meeting of the Medicare Payment Advisory Commission, the agency’s commissioners suggested that they may recommend that the Centers for Medicare & Medicaid Services reduce its assortment of alternative payment model programs. As reported by MedPage Today, a draft of MedPAC’s June report to Congress states that The [Health and Human Services] Secretary should implement a more coordinated portfolio of fewer alternative payment models (APMs) that support the strategic objectives of reducing spending and improving quality. In recent years CMS’s Center for Medicare and Medicaid Innovation has tested 54 different APMs; few [...]

iqtsupport2021-03-11T06:00:58-05:00March 11, 2021|Alternative payment models, MedPAC|

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 March meeting were: Medicare beneficiary access to care in rural areas skilled nursing facility value-based purchasing program and proposed replacement streamlining CMS’s portfolio of alternative payment models balancing efficiency with equity in Medicare Advantage benchmark policy relationship between clinician services and other Medicare services revising Medicare’s indirect medical education payments to better reflect teaching hospitals’ costs Medicare’s vaccine coverage and payment separately payable drugs in the hospital outpatient prospective payment system MedPAC is an independent congressional agency [...]

iqtsupport2021-03-10T06:00:08-05:00March 10, 2021|Medicare, MedPAC|

MedPAC Meets

Last week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues. The issues on MedPAC’s October agenda were: the skilled nursing facility value-based payment system future research directions in hospice payments Medicare Advantage benchmark policy indirect medical education: current Medicare policy, concerns, and principles for revising the evolution of Medicare’s advanced alternative payment models vertical integration and Medicare payment policy MedPAC is an independent congressional agency that advises Congress on issues involving the Medicare program. While its recommendations are not binding on either Congress or the administration, MedPAC is highly influential in [...]

iqtsupport2020-10-09T06:00:26-04:00October 9, 2020|Alternative payment models, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|

MedPAC Meets

Last week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues. The issues on MedPAC’s November agenda were: MedPAC’s mandated report on long-term care hospitals patient functional assessment data used in Medicare payment and quality measurement modifying advanced alternative payment model (A-APM) payments modifying the Medicare-dependent hospital program promoting greater Medicare-Medicaid integration in dual-eligible special-needs plans the Medicare Advantage quality bonus program Medicare Advantage encounter data MedPAC is an independent congressional agency that advises Congress on issues involving the Medicare program. While its recommendations are not binding on either Congress or the [...]

iqtsupport2018-11-06T06:00:50-05:00November 6, 2018|Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

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|

MedPAC Delivers Annual Report to Congress

The Medicare Payment Advisory Commission has issued its annual report and recommendations to Congress. The major issues addressed in the report include: implementing a unified payment system for post-acute care reforming Medicare payment for drugs under Part B redesigning the merit-based incentive payment system (MIPS) and strengthening advanced alternative payment models using premium support for Medicare the relationship between clinician services and other Medicare services payments from drug and device manufacturers to physicians and teaching hospitals in 2015 the medical device industry stand-alone emergency departments hospital and skilled nursing facility use by Medicare beneficiaries who reside in nursing facilities the [...]

iqtsupport2017-06-21T06:00:29-04:00June 21, 2017|Medicare, Medicare post-acute care, MedPAC|