Tagged with ACO Accountable Care Organizations

Massachusetts Introduces New Medicaid Rules

Massachusetts’ Medicaid program, MassHealth, has implemented major changes to the structure of the program, including shifting to accountable care organizations, allowing health care providers to address social determinants of health, and reimbursements will be tied to provider performance.

Department of Health and Human Services Announces Future Changes to Provider Reimbursements

The Department of Health and Human Services (HHS) has announced its plans to overhaul the way the federal government reimburses providers. The Department states, in an effort to improve technology and transparency, it will make changes to interoperability, price transparency, and care delivery through Medicare and Medicaid, and remove regulations that hinder private innovation.

Massachusetts – HPC Certifies 17 Health Care Organizations through New ACO Program

In an effort to bring transparency and to identify best practices and areas for improvement, the Massachusetts Health Policy Commission (HPC) has announced a first-of-its-kind, state-wide, all-payer initiative. Seventeen organizations have already been certified though the state’s new Accountable Care Organization (ACO) certification program.

Senate Finance Committee Approves Chronic Care Bill

The Senate Finance Committee unanimously passed the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017. The legislation seeks to expand telehealth services to Medicaid populations and has received a favorable score by the Congressional Budget Office.

CMS gives over 800K Physicians Reprieve from MACRA Reporting in 2017

CMS has sent over 800,000 letters to clinicians, with notification that they will not be evaluated under the MACRA Merit-based Incentive Payment System (MIPS) in 2017. Federal officials predict only about one-third of clinicians will have to file quality reports this year under the new Medicare payment system.

Congress to Revisit Telehealth for Chronic Care Legislation

The CHRONIC Care Act of 2017 was reintroduced to Congress this month. The proposed bill targets Medicare payment reform for chronic disease management services and would promote the use of telehealth by eliminating geographic restrictions on telestroke consult services, expand telehealth coverage under MA part B, and give ACOs more flexibility to use telehealth services.

CMS Pediatric Care Improvement RFI Extension Announced

CMS announced that it will extend the deadline for comments on the Request for Information (RFI) seeking input on the design of alternative payment models (APMs) focused on improving the health of children and youth covered by Medicaid and CHIP through April 7.

2018 ACO Application Cycle Details Announced

CMS released key deadlines and other important application cycle details information for applying to become a Next Generation ACO or Medicare Shared Savings Program ACO with a 2018 start date.

VT – ACO Pilot Project Announced

Vermont has entered into a one year agreement with OneCare to launch an ACO pilot program serving 30,000 Medicaid beneficiaries.

New Final Rule Targets Pass-Through Payments

CMS’ newest Medicaid managed care final rule will prevent increases in pass-through payments as well as the addition of new pass-through payments beyond those in place when the pass-through payment transition periods were established.

CMS Launches ACO Model for Dual Eligibles

CMS is introducing a new ACO model for patients enrolled in both Medicare and Medicaid. Responding to the dilemma of organizations not being held accountable for Medicaid costs for many dual-eligibles attributed to Medicare ACOs, the new model will build upon the agency’s existing Medicare Shared Savings Program with a focus on improving the cost and quality of those services, in addition to improving the value of Medicare services.

VT – All-Payer ACO Will Set to Begin January 2017

As of January 2017, Vermont will become the first state in the nation to move to a voluntary all-payer accountable care organization model. CMS will provide Vermont with $9.5 million in start-up funding to support the transition and the demonstration, funded through a 1115 waiver, that will last five years. The Vermont ACO will cover Medicare, Medicaid and commercial payers, requiring those who participate to pay similar rates for all services.

CMS Releases Final 2017 Physician Fee Schedule

CMS has issued the final rule updating the Medicare’s physician fee schedule for 2017. Under the final rule, physician payment rates increase slightly, as called for by the Medicare Access and CHIP Reauthorization Act.

All Payer ACO Model Receives Tentative Approval

Vermont has been granted tentative approval to establish an all-payer reimbursement system. If granted final approval, the All Payer Accountable Care Organization (ACO) Model would be effective for five years beginning January 1, 2017.