Value-based payment models, including accountable care organizations, bundled payment models, and capitation models, can generate savings for providers and limit healthcare spending. As healthcare spending escalates in the US, stakeholders have...
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Outcomes-based models are spreading, but fee-for-service still dominates payment landscape. Is value-based care having a moment? Health care policy experts and institutions have long agreed that fee-for-service (FFS) medicine is wasteful...
More InfoMedicare Advantage beneficiaries who received care under value-based payment models, including two-sided risk models, saw lower acute care use than beneficiaries under a fee-for-service model. Medicare Advantage beneficiaries whose primary care...
More InfoKeep these challenges in mind when choosing an alternative payment model for your practice. The Center for Medicare and Medicaid Innovation (CMMI) is promoting Alternative Payment Models (APMs) as a tool to reel in costs while improving patient...
More InfoNew data from LAN shows modest progress with value-based reimbursement adoption in 2019 and 2020. But some programs, like Medicare Advantage, are moving to financial risk faster than others. Most healthcare payments made in 2020 were tied in some...
More Info. The End-Stage Renal Disease (ESRD) Treatment Choices Model is the first to undergo changes to directly address health equity—a new goal for CMS-run alternative payment models. The ESRD Treatment Choices (ETC) Model is a mandatory alternative...
More InfoThe delivery and payment of care will look a lot different by 2030, according to CMS. The federal agency has announced that it expects all Medicare beneficiaries with Parts A and B to be in a care relationship with accountability for quality and...
More InfoAMGA expressed some concerns following CMS’ decision to extend its postponement policy regarding ACO financial risk advancement in the Medicare Shared Savings Program. The American Medical Group Association (AMGA) recommended several steps...
More InfoComments on the 2021 Medicare Physician Fee Schedule proposed rule centered on potential payment cuts, telehealth reimbursement, and quality reporting changes. Provider groups are concerned that some proposals in the Medicare Physician Fee...
More InfoTelehealth reimbursement expansions granted during the PHE may be limited to providers in Advanced APMs moving forward to prevent program integrity issues, MedPAC said at a recent meeting. The Medicare Payment Advisory Commission (MedPAC) is the...
More InfoTelemedicine reimbursement and other regulatory flexibilities enabled providers to quickly pivot operations for COVID-19, but temporary policies also poised the health policy landscape for significant change after the pandemic. In the wake of the...
More InfoCMS is proposing changes and a three year extension to the Comprehensive Care for Joint Replacement Model (CJR), which provides a flat set of payments to hospitals for an episode of care through 90 days past patient discharge. The program was due...
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