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policy

The association urged CMS to adequately reimburse off-campus, provider-based departments; refine physician quality reporting; and codify a definition of essential hospitals.

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policy

A proposed rule for the Medicare Physician Fee Schedule for calendar year 2023 would extend telehealth regulatory flexibility, make changes to the Medicare Shared Savings Program, and revise the Quality Payment Program.

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policy

CMS proposes to decrease the conversion factor determining physician payment rates for specific services by $1.53. The proposed rule also includes provisions related to Medicare reimbursement of telehealth services, vaccine administration, and the Medicare Shared Savings Program.

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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

Final rules for Medicare’s OPPS and PFS for CY 2022 continue Medicare Part B drug payment cuts to hospitals in the 340B Drug Pricing Program; continue site-neutral payment policies; and halt elimination of the inpatient-only (IPO) list.

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policy

The rule adjusts the conversion factor used to determine physician payment rates and includes provisions related to appropriate use criteria, Medicare reimbursement for telehealth services, vaccine payment rates, the Quality Payment Program, and the Medicare Shared Savings Program.

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policy

The calendar year 2022 Physician Fee Schedule proposed rule includes provisions on Medicare payment for telehealth services, the Quality Payment Program, and more. The association also responded to a request for information on improving health equity through data collection.

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policy

CMS on Aug. 2 released its fiscal year 2022 Inpatient Prospective Payment System final rule, which includes payment and quality reporting provisions. The rule does not finalize provisions related to new residency slots, organ acquisition costs, or Section 1115 waiver days. 

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policy

Proposed rules for Medicare’s Outpatient Prospective Payment System and Physician Fee Schedule would continue Medicare Part B cuts, continue site-neutral policies, and halt the phase-out of the inpatient-only list. Both rules also contain an information request on closing the health equity gap.

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policy

The rule includes provisions related to telehealth, vaccine payment rates, the Quality Payment Program, and the Medicare Shared Savings Program; comments are due to CMS by Sept. 13.

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policy

A proposed rule from CMS includes numerous changes for Medicare’s Inpatient Prospective Payment System for fiscal year 2022, including a 2.8 percent increase in inpatient payment rates and updates to quality reporting programs and the Medicare Shared Savings Program.

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policy

The Centers for Medicare & Medicaid Services’ proposed fiscal year 2022 Inpatient Prospective Payment System rule would increase operating payment rates by 2.8 percent, repeal market-based data collection, and add 1,000 new graduate medical education teaching slots, among other provisions.

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policy

CMS establishes a conversion factor of $32.41 — a decrease of $3.68 from CY 2020. The final rule also includes provisions related to Medicare reimbursement for telehealth services, the Quality Payment Program, and the Medicare Shared Savings Program.

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policy

CMS proposes to decrease the conversion factor determining physician payment rates for specific services by $3.83. The proposed rule also includes provisions related to Medicare reimbursement of telehealth services, the Quality Payment Program, and the Medicare Shared Savings Program.

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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

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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policy

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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policy

The calendar year 2020 proposed rule includes updates to the Quality Payment Program, a request for information on the creation of Merit-based Incentive Payment System Value Pathways, and other topics of interest to essential hospitals.

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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

Providers interested in the professional or global options under the new Primary Cares Initiative must submit a nonbinding letter of intent by Aug. 2.

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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

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

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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

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

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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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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

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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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 Quality Payment Program combines and replaces three separate clinician quality programs with a single system for clinicians that bill Medicare Part B.

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policy

The rule includes additional cuts to new off-campus, provider-based departments (PBDs), as well as physician payment and quality program changes.

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policy

The proposed rule would further cut payments to non-excepted provider-based departments to 25 percent of the Medicare Outpatient Prospective Payment System rate and change certain quality reporting requirements.

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policy

The Medicare Physician Fee Schedule proposed rule for calendar year 2018 includes physician payment and quality program changes.

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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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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

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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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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webinar

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

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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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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

Proposed rule would update physician payment rates for Medicare services, change physician quality programs, and solicit comment on MACRA requirements.

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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

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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policy

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

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policy

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

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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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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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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

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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