CMS Takes Action to Modernize Medicare Home Health

July 2, 2018Garrett SchmittNo CommentsCMS, Home Health

Today, the Centers for Medicare & Medicaid Services (CMS) proposed significant changes to the Home Health Prospective Payment System to strengthen and modernize Medicare, drive value, and focus on individual patient needs rather than volume of care. Specifically, CMS is proposing changes to improve access to solutions via remote patient monitoring technology, and to update…

CMS proposal builds remote patient monitoring into home health reimbursement

July 2, 2018Garrett SchmittNo CommentsCMS, Home Health, post-acute care, remote patient monitoring, Telehealth, Telemedicine

Home health agencies may soon be able to include the costs associated with remote patient monitoring into Medicare reimbursement. Under a proposed payment rule (PDF) released by the Centers for Medicare & Medicaid Services (CMS) on Monday, home health providers would be able to include the costs of remote patient monitoring as an allowable cost in…

Coalition of ACOs, IT organizations throw support behind a CMS data-sharing mandate

June 27, 2018Garrett SchmittNo CommentsCMS, Data sharing

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…

New Medicare Advantage rules hold big potential for pop health

June 13, 2018Garrett SchmittNo CommentsCMS, MA, Medicare Advantage

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…

Medicare Paths to Value-Based Health Care: Which Way is Up?

June 13, 2018Garrett SchmittNo CommentsBCPI Advanced, CMS, CPC+, DPC, Medicare, MIPS, VBHC

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 Bundled Payment Programs Primed to Produce Savings

June 7, 2018Garrett SchmittNo CommentsBundled Payments, Bundles, CMS, Medicare

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….

Substantial ACO Reforms Could be Forthcoming

May 9, 2018Garrett SchmittNo CommentsAlex Azar, CMS, Farzad Mostashari, HHS

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…

Most ACOs would flee Medicare program if pushed to take on more risk

May 2, 2018Garrett SchmittNo CommentsCMS, MSSP, NAACOS

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…

How Payers Can Add More Value to Medicare Advantage Health Plans

April 17, 2018Garrett SchmittNo CommentsCCM, Chronic Care Management, CMS, MA, Medicare, Medicare Advantage, Payers, Preventive Medicine

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…

What Alex Azar wants on value-based care (and how it resembles Obama’s goals)

March 6, 2018Garrett SchmittNo CommentsAlex Azar, CMS, CMS Innovation Center, HHS, MACRA

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…

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