MedPAC to Medicare: Cut Down on Those Alternative Payment Models

June 15, 2021Garrett SchmittNo Commentsalternative payment models, APMs, CMS, MedPAC, rural hospitals

Medicare needs to streamline its portfolio of alternative payment models (APMs), the Medicare Payment Advisory Commission (MedPAC) said Tuesday in its annual report to Congress. “CMS [the Centers for Medicare & Medicaid Services] is to be commended for the vigor with which it has approached its mandate of implementing a wide variety of APMs over…

MedPAC: CMMI Should Consider a ‘Smaller, More Harmonized’ Portfolio of Alternative Payment Models

June 15, 2021Garrett SchmittNo Commentsalternative payment models, APMs, CMMI, CMS, Home Health, Medicare, MedPAC

To reduce redundancies and confusion in the Medicare system, health care policymakers should consider implementing “a smaller, more harmonized” portfolio of alternative payment models (APMs). That’s according to the Medicare Payment Advisory Commission (MedPAC), which released its regular June report to Congress on Tuesday. “In many cases, providers participate in multiple [alternative payment models] simultaneously,…

New ACO Playbook: Three Touchstones For ACO Viability

May 13, 2021Garrett SchmittNo CommentsACOs, alternative payment models, community, coordination of care, Data, Fee for service, growth orientation, Hospital led ACOs, Medicare ACOs, MSSPs, physician-led ACOs, Primary Care First, Risk, technology, vbc

Some believe that an ACO’s leadership structure predicts its success. They point to differing savings results for physician-led versus hospital-led ACO shared savings models (MSSPs) to make their case. In particular, they make the argument that future Value-Based Care (VBC) policies should benefit the growth of successful physician-led ACOs, protecting them from policies that force…

New Rules for Some Medicare ACOs Are No Good, Say Healthcare Groups

May 12, 2021Garrett SchmittNo CommentsAlternative Payment Model Performance Pathway, alternative payment models, APP measures, CMS, Medicare ACOs, MSSPs

Groups representing doctors, hospitals, and accountable care organizations (ACOs) are pushing back on changes to quality reporting rules for Medicare Shared Savings Program (MSSP) ACOs that were finalized under the Trump administration. “We have significant concerns about the MSSP quality policies finalized at the very end of 2020,” a group of 11 healthcare organizations, including…

How Fowler Plans to Refresh CMMI’s Value-Based Care Vision

April 20, 2021Garrett SchmittNo CommentsACA, alternative payment models, Biden, CHART, CMMI, COVID-19, Fowler, Global and Professional Direct Contracting Model, health equity, NAACOS, Risk, vbc

The healthcare system is at a critical point in its transition to value-based care a decade after implementation of the Affordable Care Act and its Center for Medicare and Medicaid Innovation (CMMI), according to CMMI’s newly minted director Liz Fowler, PhD, JD. “The goal [of the ACA] was to create a system that rewards better…

Pause to Alternative Payment Models Gives Some Providers a ‘Golden Ticket,’ Leaves Others Behind

April 20, 2021Garrett SchmittNo Commentsalternative payment models, Biden, CMMI, CMS, DCEs, Global and Professional Direct Contracting Model, Medicare

The Global and Professional Direct Contracting Model — a Center for Medicare & Medicaid Innovation (CMMI) creation — has been put on pause. The holdup is just another example of CMMI pumping the brakes on an alternative payment model in the days since the Biden administration took over the executive branch. Broadly, the Global and…

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