Archive for CMMI

 

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.…

CMS Ponders Future of Medicare Payment Models

The new administration has delayed the planned launch of several new Medicare payment models and ultimately may choose not to move forward with some or to alter them.

The models currently under review by the Centers for Medicare & Medicaid Services are:

  • Primary Care First
  • Kidney Care Choices
  • Geographic Direct Contracting
  • Part D Payment Modernization Model

Learn more from the Becker’s Hospital Review article “CMS payment models that are under review, delayed.”…

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 …

Feds Looking to Bundle Medicare Post-Acute Payments?

Bring us your ideas for bundling Medicare post-acute-care payments, the head of the Center for Medicare and Medicaid Innovation recently told a gathering of hospital officials in Washington, D.C.

As reported by Fierce Healthcare, CMMI director Adam Boehler told hospital officials that

Now is the time to bring us ideas.  We’re really in listening mode…I think there’s been a lot of intrigue and interest we’ve heard from people.  So we’re gathering stakeholder input there on that and it’s a great time to give us thoughts on where we can lower costs.

Learn more from the Fierce Healthcare article “CMMI’s Adam Boehler: ‘Now is the time’ to bring post-acute care bundle ideas.”

CMS to Consider Model Behavioral Health Payment and Delivery Program

The Center for Medicare and Medicaid Innovation has invited interested parties to weigh in on the possibility of creating a new Medicare model program for behavioral health care delivery and payment.

According to a notice published in the Federal Register,

The Innovation Center is interested in designing a potential payment or service delivery model to improve health care quality and access, while lowering the cost of care for Medicare, Medicaid, or CHIP beneficiaries with behavioral health conditions. The model may include participation by other payers, qualify as an Advanced Alternative Payment Model (APM), improve health care provider participation in telehealth services, and address the needs of beneficiaries with deficits in care in the following potential areas leading to poor clinical outcomes or potentially avoidable expenditures: (1) Substance use disorders; (2) mental disorders in the presence of co-occurring conditions; (3) Alzheimer’s disease and related dementias; and/or (4) behavioral health workforce challenges.

The agency is hosting a public meeting at its headquarters in Baltimore in September to solicit ideas.

Learn more about the concept and the agency’s intentions in this Federal Register notice.…