Oct 19, 2017 11:30:00 AM

Employers Are Catalyzing Payment Model Reform; Are You with Them?

Employers increasingly are holding providers accountable for outcomes, and providers that can’t adapt will have a hard time competing.

As they continue to seek solutions to rising healthcare cost, employers are working with providers and health systems to optimize the value of their healthcare spend through options such as onsite care clinics, wellness programs, and value-based payment models for healthcare.

Continue reading >

Topics: Payment Models, APMs

Aug 17, 2017 11:30:00 AM

What Small Medical Groups Need to Know About Virtual Groups - Part 2

By banding together into what CMS has termed “virtual groups,” solo practitioners and small medical groups can take advantage of significant flexibility currently available to help them succeed in the Merit-based Incentive Payment System (MIPS).

In Part 1 of this series, we answered some FAQs about these MIPS virtual groups. In Part 2, we share items to consider before joining a virtual group.

Continue reading >

Topics: APMs, MIPS Healthcare, MACRA Summary

Aug 3, 2017 2:00:00 PM

What Small Medical Groups Need to Know About Virtual Groups for MIPS Reporting – Part 1

Small physician groups and solo practitioners take heart: CMS wants you to be successful in the Merit-based Incentive Payment System (MIPS) without having to merge or be acquired.

Continue reading >

Topics: APMs, MIPS Healthcare

Jul 27, 2017 11:00:00 AM

Is It Time to Transition From CCMAs to APMs?

A Bridge for Healthcare Reform

Over the past decade, clinical co-management arrangements (CCMAs) have risen in popularity as a means to achieve a more integrated care delivery model. CCMAs have often been touted as an interim strategy to bridge hospitals to newer emerging models, but many hospitals have yet to cross that bridge.

Continue reading >

Topics: Healthcare Reform, Payment Models, APMs

Jul 13, 2017 11:00:00 AM

What’s the Value of Innovation? (Part 2)

The previous installment of this blog series described the CMS Innovation Center and its mission to test innovative payment and delivery models and to implement the MACRA Quality Payment Program (QPP).

The QPP is designed to help achieve HHS’ goal of tying half of Medicare fee-for-service payments to quality or value through Advanced Payment Models (APMs) by 2018. Advanced APMs, one of the two tracks of MACRA, allows physician practices to earn more by assuming some financial risk related to patients’ outcomes. Certain Accountable Care Organizations (ACOs) in the Medicare Shared Savings Program (MSSP), including the new MSSP Track 1+ ACO, qualify as Advanced APMs.

Continue reading >

Topics: Value-Based Care, APMs, Quality Payment Program, MACRA Summary

Jun 26, 2017 10:00:00 AM

Top Takeaways from MACRA Proposed Rule

With the proposed changes to the Quality Payment Program (QPP) released Wednesday, the new administration aims to reduce some administrative complexity and extend the flexibility that CMS provided in the initial year of the program, while incentivizing more providers to move into Alternative Payment Models (APMs).

Continue reading >

Topics: APMs, MACRA Summary

Jun 22, 2017 4:00:00 PM

What’s the Value of Innovation? (Part 1 in a 2-part series)

The Affordable Care Act created the CMS Innovation Center to allow Medicare and Medicaid programs to test innovative payment and delivery models that improve patient care and lower healthcare costs.

Continue reading >

Topics: Affordable Care Act Summary, APMs

Jun 15, 2017 10:00:00 AM

A Primer on Operationalizing Alternative Payment Models

MACRA’s anticipated future impact on the healthcare industry has many provider organizations contemplating what actions and resources are necessary to participate in alternative payment models (“APMs”). Provider organizations facing the immediate options of getting involved with a CMS or commercial APM have significant operational decisions to make that will impact the future make-up of their organizations. Today we will discuss some of the considerations in preparing for APM participation.

Continue reading >

Topics: APMs, MACRA Summary

Jan 5, 2017 10:30:00 AM

Medicare-Medicaid ACO Model: Urge Your State to Apply by Jan. 20

January 20 is a significant date for healthcare providers—but not necessarily for the reason you think.

Yes, there is the inauguration of the 45th President of the United States, who has vowed to “repeal and replace” the most significant healthcare legislation in recent history.

But that date has even greater significance for the many providers across the country who are struggling to cover the cost of care of an increasingly high-risk, low-income population.

Continue reading >

Topics: Healthcare Reform, APMs, MIPS and MACRA, MIPS CMS

Dec 8, 2016 11:00:00 AM

Will MACRA Fall Victim to Repeal and Replace?

I've just returned from the National MACRA MIPS/APM Summit in Washington, D.C., where the overarching discussion centered on how to create and implement strategies that pay physicians fairly, while controlling spending in the Medicare program. It's a question we've wrestled with for almost 20 years and a challenge we must solve.

Continue reading >

Topics: APMs, MIPS Healthcare, MACRA Summary

RELATED POSTS