AMGA Calls on Congress to Advance Value-Based Care, Support Providers

Garrett Schmitt, , , , , , , ,

Congress should focus on advancing value-based care by investing in proper infrastructure, incentivizing patient engagement, and supporting continuous telehealth coverage, according to the American Medical Group Association (AMGA). The organization sent a letter to congressional leaders expressing appreciation for their efforts to support healthcare providers throughout the COVID-19 pandemic. However, the letter urged leaders to improve the Medicare program…

Most ACOs Worried About Rising Advanced APM Thresholds Next Year

Garrett SchmittNo Comments, , , , , ,

A new survey confirms a growing concern among accountable care organizations (ACOs) – most ACOs are unlikely to meet rising participation thresholds for MACRA’s Advanced Alternative Payment Models (APMs) in 2021. The survey from the National Association of ACOs (NAACOS) recently found that more than 90 percent of ACOs participating in an Advanced APM, including the Medicare Shared…

“Push-Pull” For Providers In Medicare’s Proposed 2021 Rule For Physician Fees And Quality Reporting

Garrett SchmittNo Comments, , , ,

The newly published 2021 CMS Physician Fee Schedule and Quality Payment Program (QPP) Proposed Rule reflects our harsh reality: Operate under the constraints of the COVID-19 pandemic, while moving toward uniformity and Risk. That tension is palpable in the Proposed Rule’s “push-pull” of CMS trying to continue to advance a Value agenda while stuck in the mud…

CMS Drops Proposed Rule Impacting Quality Payment Program, MSSP ACOs

Garrett SchmittNo Comments, , , , , ,

The Centers for Medicare & Medicaid Services (CMS) on Aug. 3 released a rule that proposes changes to the Quality Payment Program (QPP) and Medicare Shared Savings Program (MSSP) for 2021. According to federal officials, because providers must stay focused on the COVID-19 pandemic, the number of significant proposed changes to the programs are limited….

Leveraging Payment Reforms For COVID-19 And Beyond: Recommendations For Medicare ACOs And CMS’s Interim Final Rule

Garrett SchmittNo Comments, , , ,

The COVID-19 pandemic has significantly challenged clinician practices, hospitals, and all health care delivery organizations. Many such organizations have scrambled to build new capabilities and shift workflows to test, trace, and manage COVID-19 as well as remotely manage chronic conditions for their non-COVID patients. At the same time, health care delivery organizations are facing considerable…

CMS sends $51B in advance payments to hospitals

Garrett SchmittNo Comments

CMS announced April 9 that it has delivered more than $51 billion in payments to hospitals and other healthcare providers in the past week through the Accelerated and Advance Payment Program. CMS expanded the payment program to a broader group of healthcare providers in late March to help offset the financial impact of COVID-19. On April 7, the…

Alternative Payment Models During A Pandemic: Suspending Down-Side Risk During This Time Of National Crisis

Garrett SchmittNo Comments, ,

There have been a number of unprecedented regulatory flexibilities issued by the Centers for Medicare and Medicaid Services (CMS) in recent weeks given the COVID-19 pandemic, done with the intention of easing the burdens on the health care system to be more responsive to our patients’ needs. But one issue that has been left in…

Alternative Payment Models Save, But Drop-Out Rate Still a Concern

Garrett SchmittNo Comments, ,

Alternative payment models (APM) primarily run by Medicare have generally produced modest savings and quality improvements. However, popular APMs including accountable care organization (ACO) and bundled payment models have high drop-out rates, which may indicate a problem with downside risk, according to a new review article in Health Affairs. The article reviewed 40 APMs operated by the CMS…

New CHIME Report Indicates Slow Movement to Alternative Payment Models

Garrett SchmittNo Comments, , ,

Although legislative pressure to transition to value-based care began several years ago, movement to alternative payment models (APMs) and changes to healthcare reimbursement have been slow, according to CHIME HealthCare’s Most Wired report. The report, recently made public, was based on responses to CHIME’s 2019 Most Wired survey. CHIME (the College of Healthcare Information Management Executives) conducts…