APM | VBCExhibitHall Library

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

February 21, 2023acoAdvanced APM, AMGA, APM, APMs, COVID, COVID-19, remote patient monitoring, RPM, Telehealth

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…

Healthcare Associations Call on Congress to Spur APM Adoption

February 4, 2022acoAMA, AMGA, APG, APM, congress, NAACOS

A group of eight national healthcare associations this week called on the U.S. Congress to help move the movement around alternative payment models (APMs) forward, noting the sluggish uptake in participation among providers. The eight groups are the American Medical Association (AMA), AMGA (the American Medical Group Association), America’s Physician Groups (APG), the Association of…

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

August 5, 2020Garrett SchmittNo CommentsAdvanced APM, APM, APMs, MACRA, MIPS

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

August 4, 2020Garrett SchmittNo CommentsAdvanced APM, APM, APMs, HIE, MACRA, MIPS, NAACOS

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

May 29, 2020Garrett SchmittNo CommentsAdvanced Alternative Payment Models, Advanced APM, APM, APMs, payment reform

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…

Emergency CMS rule provides optimism for alternative payment models

May 15, 2020Garrett SchmittNo CommentsAdvanced Alternative Payment Models, APM, APMs

Hospitals and providers face unprecedented financial pressure amid the COVID-19 pandemic. Providers are losing $1.4 billion daily as they experience significant declines in patient volume, according to consulting firm Crowe. Healthcare executives are responding to the financial declines with workforce reductions, pay cuts and other cost-cutting measures. Debbie Zimmerman, MD, Corporate CMO at Lumeris, a value-based…

The Interim ACO Rule Explained: A Pause, Not A Reprieve

May 6, 2020Garrett SchmittNo CommentsAdvanced Alternative Payment Models, APM, APMs, MIPS

As the coronavirus pandemic continues to upend health care in the U.S., pressure has mounted on CMS to adjust its efforts to drive providers to adopt risk. In response, at the end of last week CMS announced a carve-out of COVID-19 patient expenses from certain reporting requirements. In this round, ACOs were on the receiving…

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

April 6, 2020Garrett SchmittNo CommentsAdvanced APM, APM, APMs

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…

Value-Based Care Defined: Know the Vocabulary of Health Care Reform

March 12, 2020Garrett SchmittNo CommentsAPM, Captitation, Corona, Coronavirus, Primary Care First

Today, as we confront a viral threat that is challenging our health system, its capacity, and how care is financed, it seems appropriate to review some fundamentals. Health care reform has been speeding down a particular track, changing how health care is covered, paid, delivered, and organized. These reforms may seem to be about health…

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

March 3, 2020Garrett SchmittNo CommentsAdvanced APM, APM, APMs

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…