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.
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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.
Rheumatologists are developing an alternative pay model to cut rebate-driven pharmacy benefit managers out of the drug channel.
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.
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.
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.
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.
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.
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.
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.
House lawmakers announced Thursday (March 15) a bipartisan caucus that hopes to influence policy on provider pay models.
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.
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.
Thirteen more accountable care organizations are participating in the Next Generation ACO model this year compared to 2017, according to CMS data.
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.
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.
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.
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.
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.
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.
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.
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