CMS published four new payment models and refinements to a current model through a notice of proposed rulemaking to further advance care coordination for Medicare FFS beneficiaries, which will begin 7/1/17.
Read More
By Kevin Counihan – The Affordable Care Act, the Medicare Part D prescription drug benefit, and a number of states’ insurance plans include reinsurance programs as a way to promote stable, affordable health coverage.
By Jeff Jones – Encouraging physicians to switch to EHRs has been a long term effort from CMS ever since the January 2009 passage of the HITECH act.
CMS issued a final rule to update fiscal year 2017 Medicare payment policies and rates under the Inpatient Prospective Payment System and the Long-Term Care Hospital Prospective Payment System. The final rule, which would apply to approximately 3,330 acute care hospitals and approximately 430 LTCHs, would affect discharges occurring on or after October 1, 2016.
CMS opened the application period for practices to participate in the new nation-wide primary care model, Comprehensive Primary Care Plus (CPC+). CPC+ is a five-year primary care medical home model beginning January 2017 that will enable primary care practices to care for their patients the way they think will deliver the best outcomes and to pay them for achieving results and improving care.
By Matt Fisher – With healthcare gradually (or rapidly) moving from a fee for service (FFS) world to a value-based care world, questions about the laws and regulations governing relationships within healthcare are increasing. The predominant current regulatory framework, exemplified by the Stark Law and Anti-Kickback Statutes.
By Mordy Pelleg – For clinicians working in the complex American healthcare system, getting paid for every single procedure, service and visit has always been something of a challenge. Yes, fee-for-service medicine created a fairly linear relationship between effort and remuneration, but even in that scenario many hospitals and practices have teetered on the edge of solvency, in part for lack of efficient billing practices.
The Centers for Medicare & Medicaid Services finalized new rules that will enrich the Qualified Entity Program by expanding access to analyses and data that will help providers, employers, and others make more informed decisions about care delivery and quality improvement.
On July 7, CMS proposed changes to the Physician Fee Schedule to transform how Medicare pays for primary care through a new focus on care management and behavioral health designed to recognize the importance of the primary care work physicians perform. The rule also proposes policies to expand the Diabetes Prevention Program within Medicare starting January 1, 2018.