A decade ago, the federal government launched its large-scale Medicare Access and CHIP Reauthorization Act (MACRA) in an attempt to move more physicians into value-based care to rein in exploding costs and improve care. Later this summer, Medical Economics will release the second edition of Medical Economics Insider featuring an in-depth look at how successful MACRA has been…
The Trump administration proposed a sweeping physician payment rule on Monday that rewrites Medicare payment to comply with recently passed GOP tax and policy law — and decade-old healthcare legislation. The CMS’ proposed physician fee schedule for 2026 includes a base rate hike of 2.5%. The increase was a handout to providers in the controversial “One…
On July 4, President Donald J. Trump signed into law the legislation and spending plan known as the One Big Beautiful Bill Act (OBBBA). The bill has a number of effects across different sectors of the economy, including health care. This slideshow compiles some facts, figures and responses from a variety of sources that analyzed…
A decade ago, the federal government launched its large-scale Medicare Access and CHIP Reauthorization Act (MACRA) in an attempt to move more physicians into value-based care to rein in exploding costs and improve care. In July, Medical Economics will release the second edition of Medical Economics Insider featuring an in-depth look at how successful MACRA has been and what…
Value-based payment programs tie healthcare reimbursement rates to quality care by offering providers incentive payments to meet specified quality measures during and after healthcare delivery. As the industry moves away from fee-for-service models and toward value-based care models, CMS has implemented several programs to improve patient care, advance population health, and lower healthcare costs. These value-based…
Over the last ten years, policymakers of both parties have identified health care payment reform as a critical national priority. Payment incentives offered by Medicare and other large payers create the environment in which providers must choose between being rewarded for performing more services and procedures, as in fee-for-service medicine or, for efficiently managing the…
The Medicare Access and CHIP Reauthorization Act (MACRA) has neither fueled growth in alternative payment models (APMs) nor has it imposed any significant payment differential based on value in the Merit-based Incentive Payment System (MIPS). Currently, the maximum increase MIPS offers is 1.86%, and in 2018, nearly all (98%) eligible clinicians had a positive MIPS…
Earlier this month, Premier hosted a panel on value-based care (VBC), with providers from across the healthcare continuum discussing its merits and pitfalls. In attendance were members of Congress and their staffers to hear how precisely VBC has been effective and policy changes needed to continue its forward progress. One message came through above all…
In a recent post, the administrator of the Centers for Medicare and Medicaid Services (CMS) reported that the Medicare Shared Savings Program (MSSP) generated $2.6 billion in gross savings in 2019 and $1.2 billion in net savings after accounting for shared-savings payments to participating accountable care organizations (ACOs). Achieving this level of savings would constitute remarkable…
With the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), CMS did away with the Sustainable Growth Rate model. Now, they are able to reward high-value, high-quality Medicare clinicians with payment increases, while at the same time reducing payments to those clinicians who aren’t meeting performance standards. CMS intentionally wanted to make sure that…