Recently, the Center for Medicare and Medicaid Innovation (CMMI) introduced their strategic refresh “Putting All Patients at the Center of Care” to support broader, more equitable, and outcome-based healthcare delivery transformation while streamlining current and future payment models. Since its inception in 2010 as a part of the Affordable Care Act, CMS has launched over 50 innovation/pilot…
Recently, The Centers for Medicare and Medicaid Services (CMS) released a proposal for it’s 2022 Physician Fee Schedule. Over the last several years, more non-traditional modalities of healthcare have found their way into the CMS reimbursement landscape. This is promising as it suggests that CMS is aligning themselves with consumer demand and technology developments by…
CMS has released the 2022 Physician Fee Schedule and Quality Payment Program (QPP) Final Rule, and the message of these 2,414 pages is clear: CMS wants to push providers into value-based care arrangements. That intent was foreshadowed by the Proposed Rule released over the summer, which confirmed our predictions of trends under the Biden administration. Specifically, we saw a push…
The Guidehouse Center for Health Insights has just released analysis of an executive survey in conjunction with HFMA, the 2021 Risk-Based Healthcare Market Trends, that found health systems appear to be going big into risk sharing in 2022, with these percentages of respondents planning to advance into upside/downside risk sharing, professional capitation or global capitation for:…
The Center for Medicare & Medicaid Innovation (CMMI) in October announced a “strategy refresh” that would guide development of its future payment models. If executed effectively, the strategy could make a substantial difference in hospice and palliative care as well as the health care system at large, a trio of experts told Hospice News. The…
The federal agency responsible for developing new health care payment models wants every fee-for-service Medicare beneficiary to be getting care from a provider who’s part of an accountable care organization by 2030. That goal is laid out in a recent white paper from the Center for Medicare and Medicaid Innovation (CMMI), “Driving Health System Transformation—A Strategy for the CMS Innovation Center’s Second Decade.”…
People often confuse health equity with health equality, but it’s vital that healthcare professionals understand the difference. Health equality essentially means giving every person the same thing, while health equity means giving people what they need to reach the best possible outcome. This, of course, is an important distinction, as social determinants of health (SDoH) often dictate the needs…
The Next Generation Accountable Care Organization (ACO) Model has saved Medicare millions of dollars over the past four performance years. But with one more year to go due to the COVID-19 pandemic, the Model is actually operating at a loss. Next Generation ACOs have saved Medicare nearly $667 million thanks to reductions in Parts A…
Medicare Advantage plans offer members additional benefits and require less spending from the federal government compared to fee-for-service (FFS) Medicare, according to a report commissioned by Better Medicare Alliance’s Center for Innovation in Medicare Advantage. The management consulting company Milliman conducted the report by analyzing FFS Medicare and Medicare Advantage cost, enrollment, and benefit data from CMS…
The year of 2020 was dominated by the news of how COVID-19 spread around the world, and how life has been changed by the disruption of this pandemic. We have witnessed the journeys of battling the disease, dedication and sacrifices by the front-line heroes, and the emotional roller coaster of wondering when this pandemic would…