The proposed changes in the Medicare Physician Fee Schedule (PFS) for calendar year (CY) 2023 may offer incentives for provider groups to consider alternative payment models. Still, the policies will likely require more apparent benefits to significantly impact the shift to value-based care. The CY 2023 PFS proposed rule included changes to the Medicare Shared…
The COVID-19 pandemic supercharged in-home care in the U.S. Suddenly it became possible to get a house call from a primary care provider; home-based physical therapy, dialysis, or an infusion of medicine; even a full complement of hospital-level services at home became possible. And Americans overwhelmingly liked it. The Centers for Medicare & Medicaid Services…
As the nation’s largest health care payer, responsible for more than one in five dollars spent on health care within the United States, Medicare plays a key role in transitioning the health care system away from fee-for-service, which incentivizes quantity of care, and towards value-based care, which incentivizes high-quality care and smarter spending. The passage…
The Medicare Payment Advisory Commission (MedPAC) proposed streamlining Medicare alternative payment models (APMs), along with policy options for tackling pricey Part B drugs, in its June report to Congress Wednesday. In the June 2021 report, MedPAC called for reducing the number of Medicare APMs so that models running concurrently could work better together. The 2022…
April marked the 10-year anniversary of the start of the agreement period for the first Accountable Care Organizations (ACOs) in the Medicare Shared Savings Program (Shared Savings Program) – an ambitious program to reward health care providers for improving health care for people with Medicare. The program now includes 483 ACOs with over 525,000 participating…
Medicare Advantage plans may provide better access to care and lower healthcare spending for enrollees, compared to fee-for-service Medicare, according to a study from ATI Advisory conducted on behalf of Better Medicare Alliance (BMA). “Medicare Advantage continues to demonstrate that it offers important cost protections and value for Medicare Advantage beneficiaries,” said Allison Rizer, principal at ATI Advisory…
The COVID-19 pandemic has taught us it’s possible for the health care system to transform care delivery—and quickly. We saw vaccines come to market in record time, heightened cross-industry collaboration to track vaccine statuses, and virtual care use surge. Similarly, the pandemic demonstrated that value-based care delivery models, where payment is based on outcomes versus the…
Medicare Part C (Medicare Advantage) enrollment has grown more rapidly than fee-for-service Medicare Enrollment in the last decade, raising questions about changes in the characteristics of different enrollee populations for Medicare Part A only, Medicare Part A & B and Medicare Part C. Microsoft’s Precision Population Health Group partnered with CareJourney to advance understanding of…
On the heels of several years of declining or flat accountable care organization (ACO) growth in the Medicare Shared Savings Program (MSSP), 2022 only saw a modest increase in participation, with 483 ACOs partaking. The current numbers do not bode well in terms of meeting the Biden administration’s goal of having every traditional Medicare patient…
The Centers for Medicare & Medicaid Services (CMS) has announced that 11 million patients with Medicare will be treated by Shared Savings Program Accountable Care Organizations (ACOs) in 2022. According to a news release, the announcement came as part of the agency’s annual summary of the Medicare Shared Saving Program; Medicare’s national ACO program. “With…