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Spotlight on ACOs

October 29, 2019 | Daily News

Less than a week after CMS delayed the implementation of its new alternative payment model for primary care, HHS Secretary Alex Azar on Tuesday (Oct. 29) touted the model as a centerpiece of the Trump administration’s conservative vision for Medicare.

October 24, 2019 | Daily News

CMS opened applications for two of its new Medicare alternative payment models on Thursday (Oct. 24) as the Health Care Payment Learning and Action Network (LAN) officially laid out its goals to move all Medicare beneficiaries to value-based pay models by 2025.

October 22, 2019 | Daily News

Accountable care organizations praised a bipartisan Senate bill introduced Tuesday (Oct. 22) that would remove ACO patients from the regional comparison group when CMS sets benchmarks, fixing what the ACOs call the “rural glitch.”

October 21, 2019 | Daily News

A key house panel is poised to mark up this week legislation that slaps a tax on nicotine concentrates used for vaping, and another that lets consumers use tax-free health savings accounts to pay for direct pay primary care arrangements.

October 16, 2019 | Daily News

Health experts at the Urban Institute and Commonwealth Fund analyzed eight health reform proposals ranging from building off the Affordable Care Act to transitioning to a full single-payer system that covers all people in the country in a bid to help policymakers and voters understand the trade-offs of each option.

October 16, 2019 | Daily News

While many industry attorneys praise the administration’s proposed Stark Law and anti-kickback statute reforms, some provider groups are skeptical the changes would help make much difference for those navigating the regulations, particularly for those in rural areas, and suggest Congress needs to step in.

October 09, 2019 | Daily News

HHS on Wednesday (Oct. 9) released long-awaited proposals to change the physician-self referral and anti-kickback statute regulations aimed at easing providers’ participation in value-based pay models, including new, permanent exceptions to the Stark Law for value-based pay arrangements within and outside Medicare and a new safe harbor under the anti-kickback statute for certain incentives beneficiaries can access through CMS demonstrations.

October 08, 2019 | Daily News

Days after CMS unveiled a tool to help employers who are thinking about funding a health reimbursement account that workers can use to buy individual coverage (ICHRA), a private company launched a similar, interactive affordability calculator and administrative platform that can facilitate the new coverage option finalized in July.

October 02, 2019 | Daily News

An innovation center official told physicians that by 2025 the center aspires to move all Medicare fee-for-service beneficiaries into alternative pay models that include a significant amount of risk for providers.

September 27, 2019 | Daily News

Accountable Care Organizations on Friday (Sept. 27) again pushed against a new beneficiary notification requirement that is part of CMS’ ACO overhaul, but CMS says it won’t budge on the requirement just yet.

September 18, 2019 | Daily News

Traditional Medicare remains the driver of risk-based pay models, according to a report released by Premier Inc. Tuesday (Sept. 17), but a Premier official said progress is slower than the hospital group had hoped for as few providers surveyed expect their total patient percentage in these models to exceed 50% within five years.

September 12, 2019 | Daily News

The National Association of Accountable Care Organizations (NAACOS) called on CMS to pay close attention to what it sees as a dip in the number of new ACO participants for 2019 and lays out recommendations that could help entice new organizations to join the program.

September 03, 2019 | Daily News

CMS delayed requirements for accountable care organizations (ACOs) to notify beneficiaries of their assignment in order to give ACOs time to adjust, but the providers still want the requirement removed.

August 12, 2019 | Daily News

CMS cancelled the Medicare Advantage Qualifying Payment Arrangement Incentive Demonstration due to low participation rates, and some physicians may have opted not to participate partly because there was no ability to access bonuses from the Merit-based Incentive Payment System or the alternative pay models, according to the American Medical Group Association (AMGA).

July 29, 2019 | Daily News

CMS on Monday (July 29) proposed to increase Medicare payments for doctor’s office visits and abandoned its plan to pay a blended rate for certain levels of office visits starting next year.

July 25, 2019 | Daily News

Medicare Advantage plans and some Medicare advocates are asking CMS to work with plans on a framework to sustainably implement supplemental benefits for the chronically ill in 2020, coming as the Bipartisan Policy Center calls for Congress to follow MA’s lead and also authorize non-medical benefits for Medicare fee-for-service beneficiaries with chronic illnesses.

July 17, 2019 | Daily News

CMS Administrator Seema Verma on Wednesday (July 17) touted the revamped accountable care organization program, which kicked in July 1, for leading more ACOs to take on risk, but the National Association of ACOs is worried that fewer new ACOs appear to be joining the program.

July 12, 2019 | Daily News

CMS agreed on Wednesday (July 10) to turn a tobacco-use quality measure into a pay-for-reporting measure rather than a pay-for-performance measure in 2018 in response to concerns by the National Association of Accountable Care Organizations (NAACOS).

July 10, 2019 | Daily News

President Donald Trump on Wednesday (July 10) issued an executive order calling for demonstrations to revamp the kidney care sector, and HHS immediately released a mandatory pay model and multiple voluntary pay models to do so.

July 10, 2019 | Daily News

CMS on Wednesday (July 10) proposed a long-awaited bundled pay model for radiation oncology that would replace Medicare’s fee-for-service payments in certain geographic areas.