Tagged with APM Alternative Payment Models
The Office of the Health Insurance Commissioner approved health insurance premium rates in Rhode Island for 2018 that include exchange plan rate increases ranging from 5% to 12.1% for 2018.
On June 20th, CMS released its 2018 Medicare Quality Payment Program (QPP) proposed rule. Officially titled, “CY 2018 Updates to the Quality Payment Program,” the rule includes key policy updates that seek to streamline reporting requirements and simplify participation under the Merit-Based Incentive Payment System (MIPS) [Track 1] and the Advanced Alternative Payment Model (Advanced APM) [Track 2] pathways created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
CMS has issued a proposed rule that would update payment policies for the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS). The ESRD PPS proposed rule is one of several for CY 2018 that reflect a broader strategy to relieve regulatory burdens for providers; support the patient-doctor relationship in healthcare; and promote transparency, flexibility, and innovation in the delivery of care.
CMS has delayed the start date of the new bundled payment program for heart attack, cardiac bypass, and hip and femur fracture episodes of care and the new cardiac rehabilitation incentive program. The agency also delayed several conforming changes to the existing Comprehensive Care for Joint Replacement (CJR) model until 2018.
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.
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.
CMS has published an updated table accompanying the 2016 eCQM specifications for the 2017 performance period. The updated table removes the previous meaningful use domains and now aligns with the domains listed in CY 2016 Medicare Physician Fee Schedule, as well as the MIPS and Advanced APM tracks of the Quality Payment Program.
CMS has announced a new global capitation model for rural hospitals in Pennsylvania. Under the new model participating critical access hospitals and acute care hospitals will receive all-payer global budgets for a fixed amount of money that is set in advance and funded by all participating insurers, to cover inpatient and outpatient services.
CMS has finalized the cardiac and orthopedic care mandatory demonstration bundles. Additionally, the agency has added two more Advanced APMs, predicting 25% of clinicians will participate in Advanced Alternative Payment Models by 2018.
CMS Acting Administrator Andy Slavitt is urging healthcare and political leaders to continue value-based care progress made under the Affordable Care Act, including value-based care progress after MACRA implementation through universal coverage, the CMS Innovation Center, interoperable health IT, and patient-centered care.
The Physician-Focused Payment Model Technical Advisory Committee (PTAC) was established earlier this year by MACRA and is now accepting proposals for alternative payment models (APMs).
The Department of Health and Human Services (HHS) has released a fact sheet which details progress made thus far toward delivery system reform efforts. HHS states in the fact sheet that they are “making tremendous strides in advancing high-quality patient care” by working with State and private partners to drive change throughout the system by find better ways of paying providers, delivering care, and sharing information.
CMS has published the Final Rule implementing the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The Rule finalizes provisions for participation in the new Medicare Quality Payment Program (QPP) which requires eligible physicians to begin reporting data under the Merit-based Incentive Payment System (MIPS) or Advanced Alternative Payment Models (APMs) in 2017.
On October 26, CMS announced that it will publish the final list of models that will qualify as Advanced Alternative Payment Models for next year by January 1, 2017.
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.
CMS has announced the 14 regions for its national primary care model, Comprehensive Primary Care Plus (CPC+). CMS estimates that up to 5,000 primary care practices and 20,000 providers could participate in the model.