Researchers at the University of Pennsylvania recently published a white paper that proposes a roadmap for value-based care over the next decade. On March 12, the co-authors gathered virtually to discuss lessons learned over the last decade and their five key recommendations, which include aligning alternative payment models (APMs) across all publicly financed healthcare and giving health equity a…
Everyone who’s reeling from 2020 is hoping for light in 2021. Health care, especially—systems, hospitals, clinical practices and their providers—wants the pain to stop. What might lie ahead for health care next year? Here’s what we’re thinking about the near future, and what you should watch for in 2021. 1. Health care providers will be…
Everyone who’s reeling from 2020 is hoping for light in 2021. Health care, especially—systems, hospitals, clinical practices and their providers—wants the pain to stop. What might lie ahead for health care next year? Here’s what we’re thinking about the near future, and what you should watch for in 2021. 1. Health care providers will be…
Implementation of accountable care organizations (ACOs) has been occurring unevenly across the nation, with rural areas lagging behind their more urban counterparts in ACO establishment (for example, see here, here, and here). To help establish ACOs in more areas of the country, the Centers for Medicare and Medicaid Services (CMS) developed the ACO Investment Model (AIM) to provide participating ACOs…
Citing the ongoing COVID-19 public health emergency, 10 leading healthcare organizations are urging CMS not to move forward with changes to how accountable care organizations and other alternative payment models are assessed on quality in the Medicare Shared Savings Program and the merit-based incentive payment system. The proposed changes are in the 2021 proposed physician fee schedule….
A new survey confirms a growing concern among accountable care organizations (ACOs) – most ACOs are unlikely to meet rising participation thresholds for MACRA’s Advanced Alternative Payment Models (APMs) in 2021. The survey from the National Association of ACOs (NAACOS) recently found that more than 90 percent of ACOs participating in an Advanced APM, including the Medicare Shared…
Dive Brief: Clinicians who were affiliated with a health system had “significantly better” performance scores under the Merit-based Incentive Payment System than those who were unaffiliated, according to a JAMA study published Tuesday. The researchers noted, however, that the study does not determine whether affiliated physicians were providing better quality care, raising questions about the program’s…
Recently CMS released the proposed rule for the 2021 Quality Payment Program (QPP), which covers both the Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APMs). For MIPS, there was speculation leading up to the release of the rule about how the COVID-19 pandemic would impact the program for 2020 and 2021. A thorough analysis…
CMS is proposing to change quality reporting standards in the Medicare Shared Savings Program and accountable care organizations are pushing back. In the 2021 proposed physician fee schedule rule released Aug. 3, CMS proposed three main changes related to quality: a new mechanism for ACOs to report quality measures, a reduction in the Medicare Shared Savings Program’s…
The newly published 2021 CMS Physician Fee Schedule and Quality Payment Program (QPP) Proposed Rule reflects our harsh reality: Operate under the constraints of the COVID-19 pandemic, while moving toward uniformity and Risk. That tension is palpable in the Proposed Rule’s “push-pull” of CMS trying to continue to advance a Value agenda while stuck in the mud…