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The Centers for Medicare and Medicaid Services (CMS) has shown significant support for the development of Alternative Payment Models (APMs). CMS’ development and testing of 45 payment models has led to the adoption of similar models by other payers. Initial reports indicate that APMs could be key to producing the health care delivery reform necessary to decrease health care costs and increase delivery quality. However, these models are only available to select provider types, and some providers, such as emergency physicians and audiologists, have no Medicare APMs in which they can participate. To realize the full benefits of APMs, additional collaboration between CMS leadership and providers is needed to develop new models for providers who do not currently have access to them.
Background The Quality Payment Program (QPP) under MACRA is now more than three months underway into the first payment year. However, there are still many nuances of the program, specifically under the multi-payer Advanced APM option, that payers —including commercial, Medicare Advantage, and Medicaid — and clinicians need to understand before they can begin collaborating, […]
Amid a firestorm of protest, the Obama administration announced a new test model for how it will pay for Medicare Part B drugs. According to the administration, this move is in line with recent changes to payment methodologies from the Centers for Medicare and Medicaid Services (CMS) in an effort to curb escalating medical spend […]
On Friday, the Centers for Medicare and Medicaid Services (CMS) announced their proposed Medicare rate adjustments. Estimates forecast a 3.5% increase for Medicare Advantage plans after adjusting for coding practices. CMS also intends to “improve payment precision and encourage quality” with the possibility of some changes to the star rating system. The proposed changes represent […]