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Spotlight on ACOs

April 23, 2018 | Daily News

CMS is considering contracting directly with primary doctors by paying them a lump sum for the primary care services they provide to seniors who volunteer to be part of the pay model.

April 20, 2018 | Daily News

Rheumatologists are developing an alternative pay model to cut rebate-driven pharmacy benefit managers out of the drug channel.

April 17, 2018 | Daily News

Providers are proposing a Medicare alternative pay model aimed at treating opioid addicts that includes both a bonus-only option and an option the creates the prospect of bigger bonuses in return for accepting penalties for poor performance on spending measures for addiction-related services.

April 16, 2018 | Daily News

A bipartisan group of House lawmakers is asking CMS to allow Accountable Care Organizations that are not taking on risk to continue on that track for another three years.

April 11, 2018 | Daily News

The progressive think tank Center for American Progress concludes that efforts by four states -- Massachusetts, Arkansas, Oregon and Maryland -- to rein in health care costs via delivery system reforms instead of cutting eligibility and benefits offer promising models for other states, though the results are mixed.

April 10, 2018 | Daily News

One month after HHS Secretary Alex Azar said accountable care organizations are producing underwhelming results, congressional Medicare advisers signaled a willingness push providers to form two-sided ACOs, encourage more specialists to participate and, perhaps, pave the way for ACOs to become the default for traditional fee-for-service Medicare.

April 02, 2018 | Daily News

The New York health department proposed an alternative pay model that would base provider bonuses in part on estimated lifetime health care savings, which is an unprecedented approach that CMS advisers worry could lead others, such as drug companies, to seek similar treatment.

March 30, 2018 | Daily News

Avalere reports that the Medicare Shared Savings Program has reduced Medicare spending less than the Congressional Budget Office projected it would in 2010, but boosters of accountable care organizations say the report’s methodology relies on program benchmarks that are designed to calculate provider bonuses, not measure savings.

March 22, 2018 | Daily News

The CMS review of one of the first alternative pay models to be recommended by an independent outside organization is moving along swiftly, CMS Administrator Seema Verma said Thursday (March 22), and the agency plans to help doctors deal with restrictions against self-referrals that providers say impede alternative payment model development.

March 15, 2018 | Daily News

House lawmakers announced Thursday (March 15) a bipartisan caucus that hopes to influence policy on provider pay models.

March 09, 2018 | Daily News

The National Association of Accountable Care Organizations is calling for patience after HHS Secretary Alex Azar said ACOs' performance has been underwhelming, with the group arguing an ACO's success should be defined by how the organization compares to other providers, not just to CMS benchmarks.

January 30, 2018 | Daily News

Hospital groups say providers don't know enough about CMS' new voluntary bundled pay model to decide whether to participate, and ask CMS to provide more information to those interested in the model by Feb. 15 and to push back the application deadline from March 12 to March 31.

January 22, 2018 | Daily News

Thirteen more accountable care organizations are participating in the Next Generation ACO model this year compared to 2017, according to CMS data.

January 12, 2018 | Daily News

The Medical Group Management Association is asking CMS to immediately let doctors know who is eligible for an exemption from the Merit-based Incentive Payment System in 2018 in light of new exceptions.

December 04, 2017 | Daily News

The White House Office of Management and Budget is reviewing an interim final rule on “Addressing Extreme and Uncontrollable Circumstances” for the Medicare Shared Savings program.

November 16, 2017 | Daily News

A former Obama administration CMS official said Monday (Nov. 13) she worries that the move away fee-from-service reimbursement and toward alternative pay models is losing momentum.

November 08, 2017 | Daily News

The Physician-Focused Payment Technical Advisory Committee chair and vice chair asked lawmakers on Wednesday (Nov. 8) to consider letting PTAC help doctors with technical aspects of alternative pay models, giving doctors in APMs more claims data and allow for limited small-scale testing of new models.

November 08, 2017 | Daily News

In another break from Obama-era policy, CMS plans to count participation in Medicare Advantage arrangements toward pay calculations in Alternative Payment Model Incentive Payments program, according to the Quality Payment Program rule.

November 06, 2017 | Daily News

The White House Office of Management and Budget on Thursday (Nov. 2) began reviewing a final rule that would shrink the mandatory Comprehensive Care for Joint Replacement demonstration and cancel the Episode Payment Models and Cardiac Rehabilitation incentive models.

November 03, 2017 | Daily News

Many of Congress’ Medicare advisers said Thursday (Nov. 2) they could support replacing the Merit-based Incentive Payment System with an alternative the commission is developing, but two commissioners disagreed.