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Spotlight on ACOs

Tuesday, 18 April 2017

CMS is asking hospitals applying to participate in the extension of the Rural Community Hospital Demonstration to explain how rural hospital closures have affected them, and whether the applicants are filling gaps left by the closure of other hospitals.

Tuesday, 18 April 2017

The White House Office of Management and Budget is reviewing a CMS proposed rule that offers an opportunity for the new administration to put its mark on the physician pay system under development by CMS, called the Quality Payment Program.

Monday, 20 March 2017

The House Rules Committee cleared for a House vote on Tuesday legislation promoting association health plans and repealing the anti-trust exemption for the health insurance industry.

Tuesday, 20 December 2016

CMS published Tuesday (Dec. 20) regulations on mandatory bundled pay demonstrations for cardiac and joint-replacement services, even though the incoming Republican administration opposes requiring providers to participate in demonstrations that test changes to Medicare reimbursement, and the agency finished writing policy for the accountable care organization Track 1 +, which aims to get more physicians to accept the risk of penalties for poor performance.

Friday, 16 December 2016

CMS announced Thursday (Dec. 15) a demonstration that pays bonuses to accountable care organizations for reducing Medicaid spending on beneficiaries enrolled in both Medicare and Medicaid, often referred to as dual eligibles, and the federal government for the first time is letting states share in Medicare savings.

Friday, 11 November 2016

Republicans will likely spare accountable care organizations and other demonstrations that the Affordable Care Act created, health care lobbyists and analysts say, and the CMS innovation center that runs the demos is expected to survive as well, although possibly under a different name and with restrictions such as prohibiting mandatory demos and requiring provider involvement in demo designs.

Thursday, 27 October 2016

The Senate Finance Committee released wide-ranging, bipartisan draft chronic care legislation Thursday (Oct. 27) that among other reforms would extend by two years the Independence at Home demonstration, let kidney-failure patients enroll in Medicare Advantage, ease telehealth restrictions, and change how beneficiaries could be assigned to accountable care organizations.

Wednesday, 26 October 2016

CMS will unveil additional state Medicaid delivery and payment reforms before the Obama administration leaves office, and some of those reforms will help doctors receive Medicare bonuses in two years, CMS Deputy Administrator and Medicaid Director Victoria Wachino said Wednesday (Oct. 29).

Tuesday, 25 October 2016

CMS expects to give doctors more opportunities to qualify for alternative pay model bonuses in the new physician pay system by re-opening applications for 2018 participation in the Comprehensive Primary Care Plus and the Next Generation accountable care organization demonstrations and by starting two-sided risk in the Oncology Care Model in 2017, earlier than planned.

Tuesday, 18 October 2016

CMS says it's unclear what effect the recently announced pilot to reduce contractor audits of doctors participating in pay models with two-sided risk will have on Medicare's improper payment rate, though the agency has also said it believes the pilot will continue to protect Medicare program integrity.

Monday, 17 October 2016

CMS reduced the number of electronic health record requirements and shortened the reporting period to 90 days in the physician-pay system regulation published Friday (Oct. 14).

Friday, 14 October 2016

CMS says doctors participating in pay models that include penalties will be low priorities for reviews by Recovery Auditors and other contractors in a pilot scheduled to start in January.

Thursday, 06 October 2016

As providers lose hope for an administrative solution, CAPG is asking for legislation that lets CMS count Medicare Advantage pay toward the revenue thresholds that determine whether providers qualify as participating in alternative pay models under the physician-pay system that CMS is developing.

Monday, 03 October 2016

Six Part D plans that provide benefits to about 1.6 million beneficiaries will participate in the enhanced Medication Therapy Management demonstration starting in January, CMS announced Monday (Oct. 3).

Thursday, 15 September 2016

CMS on Wednesday (Sept. 14) sent the final rule for the highly anticipated MACRA physician pay system to the White House Office of Management and Budget for review.

Thursday, 08 September 2016

If providers submit at least some data, including information dating after Jan. 1 of next year, to the Quality Payment Program, they'll avoid pay cuts under the new pay system under development by CMS, Acting Commissioner Andy Slavitt announced in a blog post.

Thursday, 08 September 2016

CMS says it is too early to tell if the first round of State Innovation Model awards changed provider behavior or improved care coordination, quality and population health while reducing costs, but credits the initiative for making “notable progress” in accelerating health care change in Vermont, Arkansas, Massachusetts, Maine, Minnesota, Oregon and Vermont.

Thursday, 25 August 2016

Medicare spent $217 million more in bonuses to accountable care organizations than the ACO program saved, according to CMS figures released Thursday (Aug. 25).

Tuesday, 23 August 2016

A recent HHS report suggests delivery system reform initiatives could increase the use of telehealth, and the agency says it is looking at reimbursement in Medicaid and Medicare and ways to address licensure, access and affordability for such services.

Thursday, 11 August 2016

CMS proposes waiving some geographic telehealth restrictions in its cardiac care pay bundle, but a telehealth lobbyist said other restrictions would remain, which could discourage providers from using telehealth services.