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Spotlight on ACOs

October 14, 2016 | Daily News

CMS says doctors participating in pay models that include penalties will be low priorities for reviews by Recovery Auditors and other contractors in a pilot scheduled to start in January.

October 06, 2016 | Daily News

As providers lose hope for an administrative solution, CAPG is asking for legislation that lets CMS count Medicare Advantage pay toward the revenue thresholds that determine whether providers qualify as participating in alternative pay models under the physician-pay system that CMS is developing.

October 03, 2016 | Daily News

Six Part D plans that provide benefits to about 1.6 million beneficiaries will participate in the enhanced Medication Therapy Management demonstration starting in January, CMS announced Monday (Oct. 3).

September 15, 2016 | Daily News

CMS on Wednesday (Sept. 14) sent the final rule for the highly anticipated MACRA physician pay system to the White House Office of Management and Budget for review.

September 08, 2016 | Daily News

If providers submit at least some data, including information dating after Jan. 1 of next year, to the Quality Payment Program, they'll avoid pay cuts under the new pay system under development by CMS, Acting Commissioner Andy Slavitt announced in a blog post.

September 08, 2016 | Daily News

CMS says it is too early to tell if the first round of State Innovation Model awards changed provider behavior or improved care coordination, quality and population health while reducing costs, but credits the initiative for making “notable progress” in accelerating health care change in Vermont, Arkansas, Massachusetts, Maine, Minnesota, Oregon and Vermont.

August 25, 2016 | Daily News

Medicare spent $217 million more in bonuses to accountable care organizations than the ACO program saved, according to CMS figures released Thursday (Aug. 25).

August 23, 2016 | Daily News

A recent HHS report suggests delivery system reform initiatives could increase the use of telehealth, and the agency says it is looking at reimbursement in Medicaid and Medicare and ways to address licensure, access and affordability for such services.

August 11, 2016 | Daily News

CMS proposes waiving some geographic telehealth restrictions in its cardiac care pay bundle, but a telehealth lobbyist said other restrictions would remain, which could discourage providers from using telehealth services.

August 08, 2016 | Daily News

Medicare pay bundles could hurt accountable care organizations' performance by driving up volume while not crediting ACOs for savings that might come from the bundles, according to representatives for ACOs, hospitals and health plans.

August 01, 2016 | Daily News

CMS estimates that up to 5,000 primary care practices will participate in the agency's new Comprehensive Primary Care Plus model across 14 different areas of the country, but the agency on Monday (Aug. 1) projected far fewer patients would participate than earlier anticipated.

July 28, 2016 | Daily News

CMS' proposal to count bundled pay models as alternative pay models would help specialists earn more money under the Medicare pay system the agency is developing, but hospitals are wary of the mandatory pay bundle.

July 26, 2016 | Daily News

Although CMS wants to push more providers into risk-bearing accountable care organizations, Brookings Institution scholars and many providers say the agency could inadvertently do the opposite by making it possible for providers in ACOs that don't accept the risk of penalties to get much larger bonuses than providers in risk-bearing ACOs.

July 25, 2016 | Daily News

CMS on Monday (July 25) proposed another mandatory pay bundle, this one for cardiac care, along with a cardiac rehabilitation incentive-pay program and the addition of hip and femur fractures to the hip and knee replacement pay bundle.

July 20, 2016 | Daily News

The IRS denied a commercial accountable care organization tax-exempt status earlier this year -- though ACOs participating in the Medicare Shared Savings Program are eligible for tax-exempt charitable status -- and some say the decision raises questions about how different types of ACOs are treated as far as their tax status.

July 08, 2016 | Daily News

The House Energy & Commerce health subcommittee mulled over the Advancing Care for Exceptional Kids Act's medical home model with an enhanced federal match for medically complex children.

July 05, 2016 | Daily News

A bipartisan group of 70 House lawmakers is pressing CMS to waive, to the extent possible, certain restrictions on hospitals and post-acute care providers when they participate in alternative pay models that accept the risk of penalties.

June 13, 2016 | Daily News

CMS will let providers in the accountable care organization program participate in the Comprehensive Primary Care Plus demonstration, but CPC+ participation will not earn track one ACOs the 5 percent bonus in the new physician pay system that CMS is developing, according to a recently updated agency document on the CPC+ program.

June 13, 2016 | Daily News

CMS’ recent policy reversal that lets accountable care organizations participate in the Comprehensive Primary Care Plus (CPC+) demonstration bolsters the case for letting ACOs participate in other pay-for-performance demonstrations, including the Comprehensive Care for Joint Replacement demo and the Bundled Payments for Care Improvement initiative, a provider consultant says.

June 06, 2016 | Daily News

CMS will slow the incorporation of regional spending into accountable care organization benchmarks, thereby lessening the financial hit to ACOs with spending that is higher than average in their regions, according to a regulation CMS published Monday (June 6) on the Medicare Shared Savings Program.