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Spotlight on ACOs

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.

June 12, 2019 | Daily News

The Center for Medicare Advocacy and Long Term Care Community Coalition ask CMS to make it obvious on the Nursing Home Compare website when a facility is a candidate for the Special Focus Facility program, noting the agency said it plans to make that list public.

June 10, 2019 | Daily News

The White House Office of Management and Budget on June 5 began reviewing highly anticipated changes to the Stark, or physician self-referral, law.

June 03, 2019 | Daily News

Providers and plans asked CMS for funding to tackle social determinants of health, clearer guidance for rural areas, and marketing guidance within a new Center for Medicare and Medicaid Innovation (CMMI) primary care demo.

May 31, 2019 | Daily News

Avalere says about half of providers in the voluntary Oncology Care Model could end up owing CMS money if they join a two-sided risk model with less downside than CMS’ initial offering -- the initial two-sided risk option included in the OCM could lead more than 70% of participants to owe money, according to Avalere’s analysis.

May 22, 2019 | Daily News

The Center for Medicare and Medicaid Innovation (CMMI) pushed back by a week the deadline for stakeholders to respond to a request for information (RFI) on one payment option that is part of a new voluntary primary care model, though the reason for the delay has not been made clear.

May 08, 2019 | Daily News

As lawmakers framed the watermark 2015 law that revamped how Medicare pays doctors as a step in the right direction, physician groups bombarded Senate Finance Committee members on Wednesday (May 8) with suggestions on ways to improve the law, including continuing base pay hikes for physicians over the next few years, making the 5% bonus for those participating in alternative pay models permanent and, according to one academic, eliminating the Merit-based Incentive Payment System completely.

May 08, 2019 | Daily News

Plans, providers and accountable care organizations (ACOs) are urging CMS to make the Next Generation Accountable Care Organization model permanent and more closely align its risk adjustment and benchmarking with Medicare Advantage (MA).

April 29, 2019 | Daily News

CMS says it has an audit strategy in place for the Merit-based Inceptive Payment System, and will conduct audits and data validation this year on providers’ MIPS submissions of 2017 data, coming as the agency continues efforts to recoup incentive funds from the meaningful use of electronic health records program.

April 26, 2019 | Daily News

Accountable care organizations (ACOs) and plans have expressed concern about model overlap after the Center for Medicare and Medicaid Innovation (CMMI) announced two new voluntary primary care models on Monday, prompting the National Association of Accountable Care Organizations (NAACOS) to say it will push CMS to put into writing which models ACOs can participate in even as CMS clarified for Inside Health Policy how model participation will work.

April 25, 2019 | Daily News

CMS Administrator Seema Verma said stakeholders can expect more Center for Medicare and Medicaid Innovation (CMMI) models to be mandatory and for all upcoming payment models to include resources for state Medicaid adoption as she teased new rural health models and a long-awaited radiation oncology model in a speech to the National Association of Accountable Care Organizations (NAACOS) on Thursday (April 25).

April 25, 2019 | Daily News

Plans and provider advocates are optimistic about new models for primary care introduced Monday (April 22) by HHS, but questions remain about who might be able to participate, how benchmarks might be set, and what services the models might include.

April 22, 2019 | Daily News

HHS on Monday (April 22) announced new models for primary care -- Primary Care First and Direct Contracting -- that are designed to encourage primary care providers to take on more financial risk for the outcomes of their patients and are projected to encompass a quarter of all fee-for-service Medicare beneficiaries.

April 12, 2019 | Daily News

CMS will start accepting on June 11 perspective notices from accountable care organizations that intend to join the revamped program in 2020, and the application window runs from July 1 through noon on July 29.