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The document details payment features of Medicare fee-for-service Hospital Global Budgets under the States Advancing All-Payer Health Equity Approaches and Development Model (AHEAD).

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The Transforming Maternal Health Model supports a whole-person approach to pregnancy, childbirth, and postpartum care for Medicaid and Children's Health Insurance Program patients.

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The States Advancing All-Payer Health Equity Approaches and Development Model focuses on chronic condition treatment and behavioral health.

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The Centers for Medicare & Medicaid Services is exploring a new model to promote health equity, with the goal of enhancing access to patient-centered care for underserved groups and including them in value-based care systems.

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Applications close May 31 for the two-year extension of the Bundled Payments for Care Improvement Advanced voluntary payment model.

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The CMS Innovation Center shares a progress report on its 10-year strategy and a blog post announcing plans to improve integrated specialty care.

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CMS extends for two years the Bundled Payments for Care Improvement Advanced Model and alters the accounting process for beneficiaries with COVID-19.

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CMS seeks feedback at a July 21 listening session on the 5 percent lump sum Alternative Payment Model Incentive Payment, set to expire at the end of 2022. 

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policy

The commission's June report to Congress includes illustrative policies about defining and supporting Medicare safety net providers and aligning payments across outpatient settings, among other topics of interest to essential hospitals.

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CMS released an advisory alerting certain qualifying participants in alternative payment models that the agency does not have billing information needed to disburse incentive payments. Participants who anticipated but have not received an incentive payment should submit the necessary form by Nov. 1.

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In its June report to Congress, the Medicare Payment Advisory Commission issues recommendations on issues of importance to essential hospitals, including payment for Part B drugs, alternative payment models, indirect medical education payments, and Medicare coverage of vaccines, among other topics.

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policy

The Office of Inspector General (OIG) and the Centers for Medicare & Medicaid Services (CMS) finalized rules in conjunction with HHS' regulatory sprint to coordinated care. The OIG rule modifies safe harbor protections; CMS’ rule targets undue burden of the physician self-referral law, or Stark law.

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policy

The new options are detailed in a comprehensive table for each payment model. Notably, CMS will extend the Next Generation Accountable Care Organization model through December 2021.

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A new proposed rule would extend the Comprehensive Care for Joint Replacement (CJR) model by three years and add outpatient knee and hip replacement to the definition of a CJR episode. Comments are due to CMS by April 24.

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America’s Essential Hospitals said the federal Anti-Kickback Statute and Physician Self-Referral Law should be modified to remove barriers to coordinating care for the complex patients essential hospitals serve.

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The final rules for Medicare’s Outpatient Prospective Payment System and Physician Fee Schedule for calendar year 2020 also expand access to opioid use disorder treatment and establish a prior authorization process for certain services.

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The final rule includes provisions related to the Quality Payment Program, evaluation and management services, telehealth services, and the Medicare Shared Savings Program.

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The updated resource library includes new fact sheets and guides for the Merit-based Incentive Payment System and Advanced Alternative Payment Models.

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The proposed rules seek to eliminate barriers to promoting care coordination under current fraud and abuse laws; comments are due to the agencies Dec. 31.

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To facilitate multi-payer alignment for ambulance services, the Center for Medicare and Medicaid Innovation will provide an interactive learning system with targeted learning opportunities for state Medicaid programs.

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The Centers for Medicare & Medicaid Services announced new payment models through the Center for Medicare and Medicaid Innovation to promote high-quality, coordinated care for patients with chronic kidney disease.

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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.

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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.

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The tool includes 2018 Qualifying Alternative Payment Model (APM) Participant and Merit-based Incentive Payment System APM status.

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institute

This partnership worked to improve vulnerable patients’ access to high-quality health care and help groups of providers navigate health reform.

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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.

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The rule includes updates to the Quality Payment Program and documentation and payment changes for evaluation and management services.

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In its comments, the association encouraged OIG to narrow the application of anti-kickback statute and beneficiary inducements civil monetary penalty laws to promote value and care coordination.

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Participating entities, including 832 acute-care hospitals, will receive bundled payments for certain episodes of care to promote value in care delivery.

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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.

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In the rule, the Centers for Medicare & Medicaid Services continues a policy of reduced payments to new off-campus provider-based departments; the agency also provides updates to the Quality Payment Program.

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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.

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This finalized rule provides flexibility in determining episode spending for Comprehensive Care for Joint Replacement model participating hospitals affected by a major disaster, such as a hurricane or wildfire.

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The Centers for Medicare & Medicaid Services has issued a frequently asked questions document about the new voluntary bundled payment model ahead of the March 12 deadline for applications.

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The table identifies which alternative payment models (APMs) are designated as Advanced APMs under the Quality Payment Program or the Merit-based Incentive Payment System.

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webinar

Hear the results of the Essential Hospital Institute’s research on collaborative value-based payment partnerships, and gain educational resources for future essential hospital partnerships.

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webinar

Take a deep dive into the new Bundled Payment for Care Improvement (BPCI) model, “BPCI Advanced,” with experts from Premier Inc.

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policy

Under the new payment model, a single bundled payment will cover services furnished by various providers across care settings. Participants can earn additional payment if they reduce costs over the course of a beneficiary’s 90-day episode of care while meeting quality benchmarks.

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policy

In response to an annual update to the Quality Payment Program, the association called for increased flexibility and risk adjustment for socioeconomic factors.

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