A diverse group of accountable care organizations, insurers, patient advocacy and health IT companies want the federal government to require data sharing among providers to participate in Medicare. The organizations didn’t stop there. They also urged the Centers for Medicare & Medicaid Services (CMS) to use other policy levers to drive interoperability by requiring the…
Payers will now be able to work with companies like Uber or Lyft to provide transportation, for example, as part of a more complete set of benefits for the quickly growing MA population. CMS issued a final rule in May giving MA plans more flexibility in determining the types of supplemental benefits they can offer chronically…
If you’re scratching your head about the direction of Value-Based Health Care (VBHC) in Medicare, you’re not alone. The current mix includes a swirl of separate initiatives, some new and others recently re-labeled. As CMS pushes toward VBHC, providers may feel confused and frustrated as concepts emerge that will affect multiple programs. Within the last…
Medicare’s bundled payment programs are in an opportune position to produce additional savings and create a more cost-effective public payer program with certain revisions, a new white paper from USC Brookings explains. CMS’s current bundled payment programs would achieve greater cost effectiveness by extending acute hospital reimbursement and hospital-based bundled payment episodes, argued John A….
Earlier this week, CMS (the Centers for Medicare & Medicaid Services) Administrator Seema Verma remarked that “upside-only” ACOs (accountable care organizations) that do not take on downside risk have not generated enough results to date. Now, Healthcare Informatics has learned that a CMS rule is forthcoming that could shorten the duration ACOs can stay in…
A huge chunk of organizations plan to leave the Medicare Shared Savings Program if they’re forced to take on financial risk, which could slow the government’s transition to value-based care. And it remains unclear whether the Centers for Medicare & Medicaid Services (CMS), which oversees the program, will make any sought-after changes. A recent letter from the agency, obtained by…
Payers striving to compete in the Medicare Advantage (MA) market can add more value to their health plans by taking advantage of regulatory changes established under a new final rule. Starting in plan year 2019, payers can offer a greater variety of Medicare Advantage plans with more variation of health benefits, specialized cost-sharing designs, and…
ALEX AZAR LAYS OUT VALUE-BASED CARE AGENDA — The HHS secretary’s four stated priorities, presented at a Federation of American Hospitals conference, generally mirror what the Obama administration pushed in its final years in office, POLITICO’s David Pittman reports. The methods for achieving those goals, of course, will likely look different. — Azar priority #1: Allow…
What is CMMI – the Center for Medicare and Medicaid Innovation? The Center for Medicare and Medicaid Innovation (CMMI), also known as the “Innovation Center,” was authorized under the Affordable Care Act (ACA) and tasked with designing, implementing, and testing new health care payment models to address growing concerns about rising costs, quality of care,…
The federal government on Thursday proposed a 1.84% average rate increase for Medicare Advantage plans in 2019, along with other policy tweaks that officials said are designed to strengthen the MA and Medicare Part D programs. The rate increase is a good deal higher than the 0.45% increase the agency approved for 2018. However, it…