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CMS proposes changes related to participation in the merit-based incentive payment system or Advanced Alternative Payment Models tracks.

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CMS predicts nearly all clinicians in advanced alternative payment models in 2016 would qualify for a 2019 incentive payment for participating in 2017.

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A new Centers for Medicare & Medicaid Services guide highlights technical resources for clinicians participating in the Quality Payment Program under MACRA.

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The first performance year for new cardiac episode payment models and the effective date of joint replacement regulation amendments now starts Jan. 1, 2018.

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An initiative aims to convene and support an essential providers network to promote payment and delivery reform amid uncertainty surrounding health policy.

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Over a five-year period, CMS will test the three-track AHC model, which aims to support health-related social needs of Medicare and Medicaid beneficiaries.

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The agency estimates that MA organization payment rates will increase by 0.45 percent on average in 2018, with an expected average revenue increase of 2.95 percent when accounting for coding changes.

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The delay, which applies to certain hospital outreach labs, comes after stakeholders expressed concerns about the March 31, 2017, deadline.

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The rule affects the Advancing Care Through Episode Payment Models, the Cardiac Rehabilitation Payment model, and changes to the CJR model.

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CMS projects that Medicare Advantage organization payment rates will increase by 0.25 percent in 2018.

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OIG found that the federal portion of spending on catastrophic coverage reached $33.2 billion in 2015, compared with $10.8 billion in 2010.

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CMS also expanded the Comprehensive Care for Joint Replacement (CJR) model to include surgical hip/femur fracture treatment.

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New guidance describes how off-campus hospital provider-based departments can maintain their grandfathered status when relocating due to extraordinary circumstances.

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A CMS spokesperson said the project was pulled after the agency reviewed public comments — there were more than 1,300 comments submitted, mostly negative.

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The agency released software that will help developers build applications for clinicians and their practices and make it easier for organizations to retrieve and maintain QPP measures using the Explore Measures section of the QPP website.

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Join us to discuss the policies, outlined by CMS, for the implementation of the site neutral law.

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In the rule, CMS revised its earlier position not to direct any physician fee schedule payments to non-grandfathered, off-campus hospital clinics in 2017 and, instead, established a 50 percent interim rate.

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While the final rule provides some relief from onerous proposed payment policies, it continues to put underserved communities at risk of further declines in access to care, the association says.

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The guide gives states information they need to develop actuarial rate certifications, such as benefit cost projections, pass-through payments, and risk mitigation strategies.

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With the opportunities, clinicians potentially could earn a 5 percent incentive payment for a growing list of alternative payment models in 2017 and 2018.

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Aids provided by the Centers for Medicare & Medicaid Services include fact sheets and overview documents, lists of alternative payment models, webinars and other educational tools, and support contacts.

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An Oct. 14 final rule establishes a new approach to physician payment required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA): the Quality Payment Program.

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The rule establishes a "transition year," as well as flexibility for providers to choose their participation pace.

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The Medicare Access and CHIP Reauthorization Act of 2015 requires CMS to remove Social Security numbers from beneficiaries’ Medicare cards by April 2019.

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In May, CMS paused initial patient status reviews to ensure reviews are performed consistently and the two-midnight policy is properly applied.

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A per-capita cap would allow the federal government to limit Medicaid spending by allocating a specific amount of funding based on states' enrollees.

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CMS Acting Administrator Andrew Slavitt announced the reporting options providers have to ensure they do not face a negative payment adjustment in 2019.

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CMS is seeking feedback on how to help states implement innovative payment, care delivery models consistent with MACRA's proposed Quality Payment Program.

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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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CMS is concerned that some providers might steer Medicare- and Medicaid-eligible patients into individual market plans to get higher payments.

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Review contractors will be able to use coding specificity as the reason for an audit or a denial of a claim to the extent that they did before Oct. 1, 2015.

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About America’s Essential Hospitals

America’s Essential Hospitals is the leading association and champion for hospitals and health systems dedicated to high-quality care for all, including the most vulnerable. Since 1981, America’s Essential Hospitals has initiated, advanced, and preserved programs and policies that help these hospitals ensure access to care. We support members with advocacy, policy development, research, and education.