Tagged with ACO Accountable Care Organizations
Massachusetts Medicaid administrator, MassHealth, is taking an innovative approach to control costs through implementation of a new health model that helps identify and address social determinants of health.
Massachusetts lawmakers recently approved an annual budget, in a 140-9 House vote, that will incorporate fees on businesses to be used to cover the state’s ever-rising health care costs.
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 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.
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 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.
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.
The Rutgers University, Center for State Health Policy has released a ‘Year 1’ report of the New Jersey’s Medicaid ACO demonstration, with an assessment of ACO operations and care management strategies.
CMS has granted a broad-based waiver to Vermont which gives the state the authority to initiate an all-payer ACO pilot aimed at serving 30,000 of the state’s 190,000 Medicaid beneficiaries in 2017.
Vermont has entered into a one year agreement with OneCare to launch an ACO pilot program serving 30,000 Medicaid beneficiaries.
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 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.
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 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.
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.
Creating population health strategies that focus on whole-person care for large populations can be challenging. But as the industry shifts toward patient-centered care, learning how to increase patient engagement and eventually cut healthcare costs will be crucial.
Despite debates over Medicare Advantage (MA) costs and benefits vs. traditional Medicare, MA continues to expand. It continues to be attractive for insurers and is increasingly attractive to provider-sponsored plans. MA is expected to exceed 40% of Medicare within a few years.
CMS is adding 2 more options for quality reporting in 2017. They provide more flexibility for providers to comply with MACRA requirements. By submitting partial data, or partial year data, a practice can avoid penalties.