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Spotlight on ACOs

April 11, 2019 | Daily News

The National Association of Accountable Care Organizations (NAACOS) recently sent a letter to CMS asking the agency to make a tobacco-use quality measure, which was changed by agency, into a pay-for-reporting measure rather than a pay-for-performance one since NAACOS said CMS didn’t adequately communicate changes and ACO performance scores have suffered.

February 06, 2019 | Daily News

CMS Administrator Seema Verma said the agency plans to open up the financial alignment demonstration for those dually eligible for Medicare and Medicaid to new states, and shortly afterwards duals center chief Tim Englehardt said the results are increasingly positive for those states currently participating.

February 04, 2019 | Daily News

CMS will again ask stakeholders for feedback on how to reduce regulatory burden, according to CMS Administrator Seema Verma, even as work on two separate CMS burden-reduction rules continues.

January 29, 2019 | Daily News

CMS Administrator Seema Verma on Tuesday (Jan. 29) previewed new demonstrations the agency is working on, including rural telehealth and multi-payer demonstrations, and she said the agency has spent the last year developing a way to increase provider participation in value-based care.

January 24, 2019 | Daily News

Piggybacking on providers’ requests, a bipartisan group of four House lawmakers is pressing CMS to delay the Feb. 19 deadline for applications to participate in the revamped accountable care organization program that kicks offs in July.

January 22, 2019 | Daily News

Accountable care organizations, hospitals, doctors and others are asking CMS to push back the Feb. 19 deadline for applications to participate in the revamped Medicare Shared Savings program, with 12 stakeholder groups asking CMS to move the deadline to March 29 and AMGA urging CMS to push it back further to April 19.

January 22, 2019 | Daily News

An analysis from the National Association of Accountable Care Organizations says CMS’ changes to the threshold for differentiating high-revenue and low-revenue ACOs is estimated to keep more physician-affiliated ACOs and those affiliated with Federally Qualified Health Centers from having to take on risk at a faster rate under the new Medicare Shared Savings program rules, but NAACOS says concerns remain that the system could keep ACOs from integrating specialty care.

January 10, 2019 | Daily News

The National Association of Accountable Care Organizations says CMS should give ACOs more time to apply to the revamped ACO program after the agency set a Feb. 19 deadline.

December 21, 2018 | Daily News

CMS on Friday (Dec. 21) finalized its overhaul of the Medicare Shared Savings Program by shortening the amount of time that accountable care organizations can participate in an upside-only model and reducing the shared-savings rate for ACOs that are not taking on financial risk.

December 17, 2018 | Daily News

CMS on Sunday (Dec. 16) sent an email to stakeholders clarifying that the Center for Medicare and Medicaid Innovation’s work will continue unchanged while Texas v. Azar continues moving through the courts, and the demonstrations run through the Affordable Care Act-created center will keep going as well.

November 16, 2018 | Daily News

The White House budget office on Tuesday (Nov. 13) began reviewing HHS’ request for feedback on ways to revamp the Health Insurance Portability and Accountability Act to boost efforts to coordinate care.

November 14, 2018 | Daily News

Radiation oncologists are concerned about the possibility of mandatory participation in a radiation oncology demonstration after HHS Secretary Alex Azar indicated such a model was on the way.

November 08, 2018 | Daily News

HHS Secretary Alex Azar on Thursday (Nov. 8) said CMS plans to both bring back the mandatory bundled-pay models the agency canceled last year and look at new models, including for radiation oncology.

November 08, 2018 | Daily News

CMS says about 93 percent of eligible providers in the Merit-based Incentive Payment System received a bonus for their 2017 performance and the vast majority avoided a pay cut -- though CMS Administrator Seema Verma says in a blog post that she expects performance in the program will change as the thresholds are harder to meet.

October 26, 2018 | Daily News

A bipartisan group of nine House lawmakers is asking CMS to reconsider its proposals to cut the savings Medicare accountable care organizations can earn without taking on risk and shorten the length of time before ACOs must share savings and losses with the agency.

October 09, 2018 | Daily News

CMS says about 1,300 entities have agreed to participate in the Trump administration's first advanced alternative pay model, the Bundled Payments for Care Improvement Advanced, and Christina Smith Ritter, the director of the Patient Care Models Group at CMS' innovation center said that participation reflects an understanding that value-based pay is where the health care system is heading.

October 04, 2018 | Daily News

CMS innovation center chief Adam Boehler told accountable care organizations on Thursday (Oct. 4) the agency should offer models with simplicity, predictability and transparency, but participating providers need to be held accountable for their care -- and, if not, others are waiting to take their place in the system.

September 21, 2018 | Daily News

Rep. Suzan DelBene (D-WA) is drumming up support for a letter that will ask CMS to adjust the low-volume threshold in order to include more providers in the Merit-based Incentive Payment System as part of the final 2019 physician fee schedule – an agency move that would be supported by some stakeholders like Premier and the American Medical Group Association even though the American Medical Association and others want CMS to finalize the exemption as proposed.

September 20, 2018 | Daily News

A White House budget official said HHS is being extremely deliberative about potential changes to to the Stark, or physician self-referral, and anti-kickback statutes because making changes the wrong way could increase fraud and abuse and hurt Medicare’s budget.

September 11, 2018 | Daily News

The National Association of Accountable Care Organizations and Institute for Accountable Care say CMS should back away from cuts to the shared savings rate for ACOs in its new model, give providers at least three years and as many as five before they need to take on risk and allow beneficiary risk scores to change by up to 5 percent during ACO contracts.