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Navigating Value-based Payment
In the 14 years since passage of the Affordable Care Act (ACA) and 9 years since the passage of the Medicare Access and CHIP Reauthorization Act (MACRA), there have been numerous programs developed by Medicare, states and commercial payers to support the movement to outcomes or value-based reimbursement.
Capitated and Global Budget Models
At the upstream end of the value-based payment spectrum, organizations can assume full risk for a population through capitated payments, global budgets, and provider led insurance plans.
CMS, OIG Finalize Changes to Stark Law and Anti-kickback Statute to Encourage Value-Based Care and Reduce Technical Trip Wires
Summary of two final rules from the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services Office of Inspector General (OIG) that will modernize and make important changes to physician self-referral (Stark law) and federal Anti-kickback statute (AKS) regulations.
Special Bulletin: Highlights of HHS Final Regulations to Modernize Stark and Anti-kickback
The Department of Health and Human Services (HHS) on Nov.
House Leadership Urged to Address Impending MACRA Changes
Nearly 30 representatives encourage House leaders to modify in the next COVID-19 response package impending thresholds for qualifying participants in Advanced Alternative Payment Models, which they said threaten to “derail” the movement to value-based care under the Medicare Access and CHIP Reauthorization Act.
Coalition Voices Support for the Value in Health Care Act of 2020
Thirteen organizations representing health care providers, including the AHA, voiced support for the Value in Health Care Act, legislation to strengthen Medicare’s value-based payment models and accountable care organizations.
CMS Urged to Extend CJR on Voluntary Basis, Hold Hospitals Harmless In 2020
AHA supports extending the Comprehensive Care for Joint Replacement model for an additional three years, but only on a voluntary basis, the association told the Centers for Medicare & Medicaid Services.
AHA Comments on CMS’s Proposed Rule Modifying Stark Law
The AHA applauded “the new direction” the Centers for Medicare & Medicaid Services is taking to modify, modernize and clarify the physician self-referral law, also known as the Stark Law, to “provide space for the types of innovative arrangements among hospitals and physicians that can enhance care coordination, improve quality and reduce costs.”
Special Bulletin: HHS and CMS Announce Primary Cares Initiative
The Department of Health and Human Services and the Centers for Medicare & Medicaid Services April 22 announced a new Primary Cares Initiative.