Tagged with APM Alternative Payment Models
The Promoting Integrity in Medicare Act (PIMA) seeks to update Medicare policies by preventing self-referrals related to advanced imaging services, radiation therapy, anatomic pathology and physical therapy.
On November 1, CMS released its Medicare Physician Fee Schedule final rule for calendar year (CY) 2019. The latest update includes changes to the Quality Payment Program as well as documentation and payment adjustments for evaluation and management services.
New data released by CMS shows 93% of eligible clinicians who participated in the Merit-Based Incentive Payment System (MIPS) under the Quality Payment Program (QPP) received positive payment adjustments for their MIPS performance last year.
CMS and the National Library of Medicine (NLM) has published the most recent updates to the electronic clinical quality measure (eCQM) value sets. The updated sets include ICD-10 Clinical Modification (CM) and Procedure Coding System (PCS), SNOMED CT, LOINC, and RxNorm.
The American Medical Association (AMA) and the American Society of Addiction Medicine (ASAM) have announced plans to pilot test a model that includes medications combined with psychosocial support.
CMS on January 8th introduced its new voluntary bundled payment model, Bundled Payments for Care Improvement Advanced (BPCI Advanced).
CMS has launched a new data submission system for clinicians participating in the Quality Payment Program (QPP), designed to reduce administrative burdens and streamline the data submission process.
Providers and insurance groups are in favor of CMS’ plans to develop a demonstration project that will test the effects of allowing clinicians to receive credit for financial risk-based arrangements with Medicare Advantage (MA) plans.
CMS, on October 31st, announced that electronic clinical quality measures (eCQMs) in CMS quality programs will be transitioned to use the Clinical Quality Language (CQL) standard (CQL Release 1, Standard for Trial Use (STU) 2) for logic expression. Additionally, CMS has issued revised technical release notes (TRNs) for the addendum to the electronic clinical quality measure (eCQM) annual update specifications for 4th Quarter 2017 reporting and 2018 reporting periods.
CMS has released an addendum to the electronic clinical quality measure (eCQM) annual update specifications originally published in May 2017. This addendum updates eCQM value sets for the 2018 performance period for Eligible Professionals (EPs) and Eligible Clinicians (ECs).
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.