Tagged with APM Alternative Payment Models

CMS Announces Transition of eCQMs to CQL for CY2019 Reporting Periods

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.

2018 eCQM Value Set Addendum for EPs, ECs Released

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).

CMS Releases Quality Payment Program Proposed Rule

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).

End-Stage Renal Disease Proposed 2018 Policy and Payment Rate Changes

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.

New Medicare Bundled Payment Models Delayed until 2018

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 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.

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.

CMS Updates cEQM Table for ECs and EPs for 2017 Performance Period

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.

PA – New Global Capitation Model for Rural Hospitals

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.

Another Step Toward Value-Based Reimbursement

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.

PTAC Now Accepting APM Proposals

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).

HHS Shares Details on Progress of Delivery System Reform Goals

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.

MACRA Final Rule Released

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.

CMS Adds Flexibility to MACRA Quality Reporting

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.

14 Regions For National CPC+ Primary Care Model

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.