For your convenience: APMs = Alternative Payment Models MIPS = Merit-based Incentive Payment System QPs = Qualifying APM Participants CEHRT = Certified Electronic Health Record Technology The MACRA rule has introduced a load of new acronyms (see above), but here is another wrinkle. What exactly is an “Advanced” Alternative Payment Model? Luckily, several attorneys […]
For your convenience: MACRA = Medicare Access and CHIP Reauthorization Act QPP = Quality Payment Program APMs = Alternative Models MIPS = Merit-based Incentive Payment System CMS has issued the much-anticipated final rule to implement the controversial Medicare Access and CHIP Reauthorization Act of 2015. MACRA replaced the sustainable growth rate formula for […]
A former Medicare official recently spoke about the “irony” of the ACO world, noting that CMS is making the deals as hard as they can be—thereby “starving ACOs.” The official, now a large system president and CEO, said there doesn’t appear to be provider resistance to ACOs; nevertheless, it was time to make some […]
Nontraditional partnerships explicitly form to manage accountable care organizations and clinically integrated networks. Shared governance is typical in these types of partnerships. Other nontraditional partnerships include insurance companies, retailers and pharmacy companies. Accountable care organizations and clinically integrated networks both collaborate among hospitals and physicians to manage large groups of patients to reduce the […]
The healthcare industry has less than six months to prepare for the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). But according to a recent survey by Deloitte, it may be an uphill battle. According to Deloitte’s 2016 Survey of US Physicians, “half of surveyed physicians have never heard of MACRA, and most […]
Smaller accountable care organization (ACO) officials wrote comments to CMS noting that some provisions of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) could hurt the viability of smaller ACOs. The proposed rule, MACRA, will split physicians into those paid under the Merit-based Incentive Payment System (MIPS) and those paid annual […]
CMS issued a final rule last week that will allow accountable care organizations (ACOs) to benchmark their results to regional Medicare spending, using a phased approach to incorporating regional fee-for-service (FFS) expenditures into calculations for resetting, adjusting, and updating an ACO’s rebased historical benchmark after an initial three-year agreement period. National benchmarks will continue […]
CMS will allow primary care practices in the Medicare Shared Savings Program (MSSP) to participate in the Comprehensive Primary Care Plus (CPC+) initiative. The announcement came in response to stakeholder concerns that a new Medicare primary care payment model could steer physicians away from accountable care organizations. Up to 1,500 eligible primary care practices […]
A new alternative payment model featuring public-private payer partnerships was announced last week by CMS. The Comprehensive Primary Care Plus (CPC+) model features Medicare-commercial-state health insurance plans partnerships to support the delivery of advanced primary care. Existing alternative payment models range from pay-for-performance, to bundled payments, to accountable care organizations, to global payments. […]
Continuing our series on excerpts of interviews with iProtean experts, we feature Larry McEvoy, M.D., on driving a sustained culture of quality. Interviewer: What are the essential tenets of a culture of quality? Larry McEvoy: I have a formula that simply describes the tenets of a culture of quality: MLN. M is […]