Archive for Alternative payment models

 

CMS Reconsidering Medicare Payment Models

Five Medicare alternative payment models previously slated for implementation are being delayed, cancelled, or reconsidered.

The five APMs whose futures are not clear are:

  • The Community Health Access and Rural Transformation Model ACO Track
  • Primary Care First
  • Kidney Care Choices
  • Geographic Direct Contracting
  • Part D Payment Modernization Model

Learn more about the Centers for Medicare & Medicaid Services’ latest actions on these models in the Becker’s Hospital Review article “5 CMS payment models that are under review, delayed.”

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MedPAC Meets

The Medicare Payment Advisory Commission met in Washington, D.C. last week to discuss various Medicare payment issues.

Among the issues discussed at MedPAC’s April meeting were:

  • Medicare skilled nursing facility value-based purchased program.
  • Medicare alternative payment models (APMs).
  • Medicare Advantage benchmark policy.
  • Medicare indirect medical education (Medicare IME) payments.
  • Medicare vaccine coverage and payments.
  • Medicare payment for prescription drugs prescribed on an outpatient basis.
  • Private equity and Medicare.
  • Medicare clinical laboratory fee schedule.

MedPAC is an independent congressional agency that advises Congress on issues involving Medicare.  While its recommendations are not binding on either Congress or the administration, MedPAC is highly influential in governing circles and its recommendations often find their way into legislation, regulations, and new public policy.

Go here for links to the policy briefs and presentations that supported MedPAC’s discussion of these issues.…

Too Many Medicare APMs?

MedPAC thinks maybe that’s the case.

At the recent meeting of the Medicare Payment Advisory Commission, the agency’s commissioners suggested that they may recommend that the Centers for Medicare & Medicaid Services reduce its assortment of alternative payment model programs.

As reported by MedPage Today, a draft of MedPAC’s June report to Congress states that

The [Health and Human Services] Secretary should implement a more coordinated portfolio of fewer alternative payment models (APMs) that support the strategic objectives of reducing spending and improving quality.

In recent years CMS’s Center for Medicare and Medicaid Innovation has tested 54 different APMs; few have led to improvements in the quality of care and even fewer have produced savings.  In 2021 the agency is scheduled to operate 13 different APMs, many with multiple payment tracks from which participants can choose.  Now, MedPAC is considering advising CMS on how to target its APMs more effectively and better align its offerings’ incentives and methodologies.

Learn more about MedPAC’s interest in Medicare APMs in the MedPage Today article “MedPAC May Tell Medicare to Slim Down Its Alternative Payment Offerings.”…

MedPAC Meets

The Medicare Payment Advisory Commission met in Washington, D.C. recently to discuss various Medicare payment issues.

Among the issues discussed at MedPAC’s January meeting were:

  • hospital inpatient and outpatient payments
  • physician and health professionals payments
  • the possible expansion of the post-acute transfer policy to hospice
  • ambulatory surgical center, outpatient dialysis, and hospice payments
  • Medicare payments for skilled nursing facilities, long-term hospitals, inpatient rehabilitation facilities, and home health services
  • the Center for Medicare and Medicaid Innovation’s development and implementation of alternative payment models
  • the future of telehealth after the COVID-19 public health emergency ends
  • a status report on the Medicare Part D prescription drug program
  • a report on the skilled nursing facility value-based purchasing program and a proposed replacement for that program
  • Medicare’s vaccine coverage and payment policies

MedPAC is an independent congressional agency that advises Congress on issues involving Medicare.  While its recommendations are not binding on either Congress or the administration, MedPAC is highly influential in governing circles and its recommendations often find their way into legislation, regulations, and new public policy.  Because so many patients of private safety-net hospitals are insured by Medicare, MedPAC’s deliberations are especially important to those hospitals.

Go here for links to the policy …

MedPAC Meets

Last week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues.

The issues on MedPAC’s October agenda were:

  • the skilled nursing facility value-based payment system
  • future research directions in hospice payments
  • Medicare Advantage benchmark policy
  • indirect medical education:  current Medicare policy, concerns, and principles for revising
  • the evolution of Medicare’s advanced alternative payment models
  • vertical integration and Medicare payment policy

MedPAC is an independent congressional agency that advises Congress on issues involving the Medicare program.  While its recommendations are not binding on either Congress or the administration, MedPAC is highly influential in governing circles and its recommendations often find their way into legislation, regulations, and new public policy.

Go here for links to the policy briefs and presentations that supported MedPAC’s discussion of these issues and here for a transcript of the proceedings.…