New Payment Models
As payment policies continue to evolve, essential hospitals are being called upon more frequently to provide value-based, patient-centered, and coordinated health care services.
The U.S. Department of Health and Human Services exceeded its goal of tying 30 percent of Medicare payments to alternate payment models — accountable care organizations and bundled payments, for example — by 2016. Like all hospitals, essential hospitals must adapt to an environment in which current payment systems are increasingly realigned to better reward improvements to the efficiency of care delivery and quality outcomes.
America’s Essential Hospitals recognizes that improving care coordination and quality while maintaining a mission to serve the most vulnerable is a delicate balance for our members. Essential hospitals also face resource challenges as they consider investments necessary for participation, whether voluntary or mandatory, in alternative payment models.
The association closely monitors and evaluates new and existing payment and delivery models to ensure they do not put our hospitals at a disadvantage or impede essential hospitals’ progress in care coordination.
Applications for the new payment models are due to the Centers for Medicare & Medicaid Services Jan. 22, 2020.view more »
An Aug. 2 final rule for Medicare’s Inpatient Prospective Payment System for fiscal year 2020 will increase inpatient operating payments and Medicare disproportionate share hospital funding and make changes to electronic health records use and quality reporting programs.view more »
To facilitate multi-payer alignment for ambulance services, the Center for Medicare and Medicaid Innovation will provide an interactive learning system.view more »
The two mandatory payment models will test prospective episode-based payments for radiation oncology therapy and end-stage renal disease treatment.view more »
The agency seeks feedback on proposed criteria for selecting direct contracting entities to participate in the new population-based payment model.view more »
The agency released a request for applications on the Emergency Triage, Treat, and Transport model for emergency ambulance services. The new model encourages treatment for Medicare beneficiaries outside the emergency department.view more »
Providers interested in the professional or global options under the new Primary Cares Initiative must submit a nonbinding letter of intent by Aug. 2.view more »
The Centers for Medicare & Medicaid Services will accept applications for its second cohort of participants in the Bundled Payments for Care Improvement Advanced Model; second cohort participants will start model year three, beginning on Jan. 1, 2020.view more »
The recently released 2017 Quality Payment Program Experience Report includes participation and performance statistics for the Merit-based Incentive Payment System and Advanced Alternative Payment Model tracks.view more »
The Emergency Triage, Treat, and Transport model for emergency ambulance services encourages treatment for Medicare beneficiaries outside the emergency department.view more »
A final rule for the Medicare Shared Savings Program overhauls the program and creates a pathway for accountable care organizations to more rapidly transition to performance-based risk models with the potential for greater shared savings.view more »
More than 1 million eligible clinicians received a neutral or better payment adjustment in the first year of the Merit-based Incentive Payment System, one of two tracks in the Quality Payment Program.view more »
The Sept. 26 webinar will review requirements for submitting value-based payment approaches as an Other Payer Advanced Alternative Payment Model under the Medicare Access and CHIP Reauthorization Act of 2015.view more »
A proposed rule for the Medicare Shared Savings Program would overhaul participation tracks to create a “glide path” along which accountable care organizations could transition from a rewards-only model to a two-sided model with risk and the potential for greater rewards.view more »
The Centers for Medicare & Medicaid Services extended to Aug. 8 the participation agreement deadline for the Bundled Payments for Care Improvement Advanced model and announced that participants can retroactively withdraw from the program in March 2019.view more »
Merit-based Incentive Payment System participants may request a targeted review of their performance feedback and final score if they find an error in their 2019 payment adjustment calculation.view more »
Clinicians eligible for the Merit-based Incentive Payment System can receive Improvement Activity credit for participating in a study on quality reporting burdens; applications are due April 30.view more »
Providers who submitted data through the Quality Payment Program website can review preliminary performance feedback. Final scores and feedback will be available July 1.view more »