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policy

The Center for Medicare & Medicaid Innovation will release a request for applications for the Realizing Equity, Access, and Community Health accountable care organization model, which will focus on promoting health equity and mitigating health disparities for underserved communities.

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policy

The proposed rules would deepen Medicare Part B cuts to hospitals in the 340B Drug Pricing Program, continue site-neutral payment policies, and revise the overall hospital star rating methodology. The association urged CMS to protect funding for essential hospitals and access to care.

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Essential Insights

The immediate urgency that the COVID-19 pandemic has placed on our delivery system’s infrastructure is both mounting and innately unpredictable. There are innovative operational strategies any hospital can implement to meet these challenges. 

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policy

The Centers for Medicare & Medicaid Services on April 30 issued a second round of waivers and rule changes to provide flexibility to hospitals and improve access to testing for beneficiaries. These changes update waivers issued March 30 to address patient surge.

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policy

Applications for the new payment models are due to the Centers for Medicare & Medicaid Services Jan. 22, 2020.

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institute

Health care practices participating in accountable care organizations (ACOs) are more likely than non-ACO practices to use home visits to manage patients who need complex care.

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policy

The Medicare Payment Advisory Commission outlines issues of importance to essential hospitals, including Medicare payment strategies for Part B drugs, the Medicare Shared Savings Program,and Medicare fee-for-service spending for emergency department services.

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policy

The Primary Cares Initiative comprises five new voluntary payment model options under two paths. The new models build on the experience of the Medicare Shared Savings Program and Next Generation Accountable Care Organization model.

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quality

The new Care Coordination Toolkit showcases the work of accountable care organizations (ACOs) participating in the Medicare Shared Savings Program and Next Generation ACO Model. The agency also released a set of case studies describing innovation ACO initiatives.

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policy

The Centers for Medicare & Medicaid Services announced notice of intent to apply and application deadlines for a Jan. 1, 2020, start date for the Medicare Shared Savings Program.

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policy

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.

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policy

The Medicare Shared Savings Program final rule creates a pathway for accountable care organizations to transition more rapidly to performance-based risk.

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policy

America's Essential Hospitals encouraged the Centers for Medicare & Medicaid Services to promote stability in the Medicare Shared Savings Program and allow essential hospitals more time to stay in savings-only tracks.

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webinar

Explore the journey taken by Broward Health and Memorial Healthcare System as they partnered with the Community Care Plan (CCP), a safety-net Provider Service Network, to administer a Medicaid accountable care organization serving Broward County.

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policy

The association urged the Centers for Medicare & Medicaid Services to adequately reimburse off-campus, provider-based departments and refine physician quality reporting to account for costs of care and the unique needs and patient populations served by essential hospitals.

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policy

New data show 472 accountable care organizations in the Medicare Shared Savings Program cared for 9 million program beneficiaries in 2017.

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policy

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.

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policy

A new proposed rule would create a pathway for accountable care organizations to more rapidly transition to performance-based risk.

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policy

The report provides updates on the Hospital Readmissions Reduction Program, off-campus emergency department access, the physician fee schedule, population-based quality measures and incentives, and Medicare accountable care organizations, among other topics.

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policy

This year, there are 124 new participants, including 55 that will take part in the risk-baring Medicare Shared Savings Program Track 1+ model; Accountable care organizations now serve 10.5 million Medicare patients, up 1.5 million from 2017.

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policy

The Centers for Medicare & Medicaid Services did not receive any letters of intent for the 2018 start date of the Medicare-Medicaid accountable care organization model.

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webinar

Discover the Vermont Blueprint for Health, a state-led initiative to transform care delivery and financing, and hear from state and essential hospital leaders about this initiative’s challenges and successes.

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webinar

Participants learned about the evolution of Medicaid Managed Care and how essential hospitals can succeed in the changing environment from experts at Premier Inc.

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policy

The fact sheet gives a general overview of the Medicare Shared Savings Program and Quality Payment Program and explains how the programs work together.

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webinar

The policy team at America's Essential Hospitals discussed the regulatory outlook for the next year, including key policy issues on the horizon.

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policy

Hospital participation in Medicare value-based programs in 2015, including ACOs and bundled payments, was associated with 2,377 fewer readmissions and $32.7 million in savings.

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policy

A series of forums will provide information on the Next Generation ACO Model; a separate CMS webinar will outline the Medicare ACO Track 1+ Model.

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policy

Along with renewing ACOs, the 99 new organizations bring the total number of ACOs nationally to 480 in 2017.

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policy

The new Center for Medicare and Medicaid Innovation model aims to boost participation from small rural hospitals and other smaller health care practices.

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policy

CMS will partner with up to six states on the new Medicare-Medicaid ACO Model, which was designed by the CMS Innovation Center.

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policy

Of particular interest to members of America’s Essential Hospitals are changes to the Medicare Shared Savings Program and provisions related to telehealth.

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webinar

Hosted by the Financial Interest Group, this webinar will help prepare your hospital to implement provisions of the MACRA final rule.

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policy

It outlines factors stakeholders should focus on when designing alternative payment models, including type to propose, how to measure improvements, and more.

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webinar

Hear insights and lessons learned regarding value-based care from representatives of the foundation of Hennepin Health.

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quality

Hospitals and other providers generated more than $466 million in savings in 2015 through participation in Medicare accountable care organizations (ACOs).

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policy

The rule, released July 7, updates physician payment rates for Medicare services and makes changes to physician quality programs.

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policy

The new rule aims to help more accountable care organizations successfully participate in the Medicare Shared Savings Program.

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policy

Hospitals and other providers now have until May 20 to submit a letter of intent for the Next Generation ACO model, which carries greater risk but also offers greater rewards; applications are due May 25.

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webinar

Join us April 20 to hear key lessons learned from a hospital currently operating an accountable care organization.

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policy

Hospitals and other providers now have until May 2 to submit a letter of intent to participate in the second and final round of the Next Generation Accountable Care Organization (ACO) Model.

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quality

New ACOs are eligible for risk-bearing tracks with increased savings for positive patient outcomes and penalties for negative outcomes. A total of 477 ACOs will care for almost 8.9 million beneficiaries in 2016.

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policy

CMS requests feedback on a range of provisions relating to MIPS and incentives for participation in APMs, including whether to stratify quality measure data by demographic factors.

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quality

Pioneer and MSSP ACOs showed improvement in at least 27 of 33 quality measures in last reporting period. More than 420 Medicare ACOs have been established, coordinating care for more than 7.8 million patients.

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policy

Upfront and ongoing savings aim to encourage providers to form ACOs in rural and underserved areas and promote participation in models with greater financial risk. Applications accepted July 1 to July 31.

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policy

Nominations are due June 19. The work group will define terms related to alternative payment models and a strategy to track progress of APM implementation.

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policy

The agency also finalized a new risk/reward model that offers a greater share of savings for providers who take on more financial risk.

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policy

Roughly 48 percent of participating ACOs produced $121 million in total shared savings in 2013, with a net shared savings of $99 million

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policy

The call will provide an overview of the materials required for applying to the Medicare Shared Savings Program and lessons learned from previous program year application periods. Notices of intent due May 29, applications due July 31.

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policy

The model saved $384 million over a two-year time period and is the first alternative payment pilot to meet criteria for expansion to additional sites.

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quality

IOM recommended a set of 15 core measures to be used across federal quality reporting programs to reduce the administrative reporting burden, allow for nationwide comparisons, and more.

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policy

This new model will allow ACOs to take greater performance risks for greater financial reward, calls start March 31.

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policy

CMS will host a national provider call for ACOs interested in the 2016 program year.

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policy

Through CMS' new model, ACOs can take greater performance risk and receive a greater portion of savings through coordinated, high-quality care.

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policy

The Network will support the transition toward alternative payment models, using efforts in the Medicare Program as a guide.

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policy

Specifically, HHS will evaluate financial assistance programs, Medicaid expansion, pioneer ACOs, and marketplace payment systems.

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policy

There is particular interest in mechanisms for greater comprehensiveness in care delivery, care for complex patients, care coordination, and value-driven reimbursement.

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policy

Recommendations include establishing greater balance between risk and reward for participating ACOs.

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institute

In recent journal articles from the New England Journal of Medicine and Medical Care, researchers explore issues related to Medicare accountable care organizations and patient-centered medical homes.

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policy

The proposals seek to add flexibility for participants and encourage participants to assume more risk to be be rewarded with greater shared savings.

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institute

A recent Health Affairs article explores how Hennepin Health uses ACO savings from decreased ED visits, better primary care to help the homeless, mentally ill.

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policy

Topics of member interest include payment updates, the OQR Program, and the MSSP.

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policy

The rules, released Oct. 31, finalized a number of provisions regarding payments, data collection in outpatient departments, quality programs, and the MSSP.

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policy

The funding will be allocated to up to 75 ACOs participating in the Medicare Shared Savings Program to bring better care coordination to rural and underserved areas.

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institute

Recent journal articles explore socioeconomic status, accountable care organizations, and other issues relevant to essential hospitals.

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policy

Explore Medicaid alternative payment models, which states have increasingly used to improve health care quality and lower costs.

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institute

Recent journal articles explore interventions to reduce readmissions, uncover barriers to recovery for vulnerable adults, decrease emergency department utilization, and more.

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policy

America's Essential Hospitals urged CMS to ensure any changes to the MSSP encourage and emphasize quality of care for beneficiaries.

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policy

CMS proposes to update how participants in the MSSP capture and submit quality metric data to gauge improvements to quality of care. The proposed update includes changes to the measure set and the benchmark time period.

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policy

OMB received June 26 a CMS proposed rule regarding the second round of the Medicare Shared Savings Program.

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policy

Providers interested in participating in an ACO through the MSSP must submit a notice of intent to CMS by May 30 and a final application to CMS by July 31.

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policy

CMS will host a National Provider Call March 18, from 1:30 to 3 pm Eastern time, on 2014 Medicare quality reporting programs. During the call, officials will provide an overview of how to report quality measures in various Medicare programs, including those for electronic health records incentives and accountable care organizations.

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policy

ACOs allow hospitals, health care providers to improve quality, slow cost growth through coordinated care while sharing in savings

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policy

Will provide high-quality, coordinated care to about 1.5 million Medicare beneficiaries

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policy

ACOs are responsible for quality, cost, and overall care of Medicare beneficiaries

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policy

Agency provides methodological considerations, questions for states to address in program proposals

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policy

CMS says all 32 pioneer ACOs improved quality, performed better than published rates in fee-for-service Medicare

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institute

Survey of literature and essential hospital experiences, supported by Aetna Foundation

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