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10 Takeaways from the 2018 MACRA Proposed Rule Print E-mail
Written by Gabriel Perna | Physicians Practice   
Thursday, 22 June 2017 00:00

This week, CMS released the proposed rule which outlines the 2018 performance year requirements of its Quality Payment Program (QPP), under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

For small practices, it should be seen as a major win, early observers of the rule say. CMS created a number of flexibilities in the QPP that will allow practices with 1 to 15 physicians (its definition of small) to either skip participation altogether or have an easier time adhering to the guidelines.

The American Medical Association (AMA) praised the rule shortly after it was released.

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Post-acute care: Medicare Advantage vs. traditional Medicare Print E-mail
Written by Austin Frakt | The Incidental Economist   
Saturday, 20 May 2017 10:46

From a public spending point of view, post-acute care is particularly problematic. Most of Medicare's geographic spending variation is due to this type of care. Part of the story is that Medicare pays for post-acute care in several different ways, with different implications for efficiency.

 For example, traditional Medicare (TM) - which spends ten percent of its total on post-acute care - pays skilled nursing facilities per diem rates but inpatient rehabilitation facilities a single payment per discharge. Post-acute care is also available through Medicare Advantage (MA), which operates under a global, per-enrollee, payment. Unlike TM, MA plans establish networks, may require prior authorization for post-acute care, and can charge more in cost-sharing for post-acute care than TM does.

These different payment models offer different incentives that may affect who receives care, in what setting, and for how long. In Health Affairs, Peter Huckfeldt, José Escarce, Brendan Rabideau, Pinar Karaca-Mandic, and Neeraj Sood assessed some of the consequences of those incentives.

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Last Updated on Friday, 16 June 2017 17:41
Lawmakers Seek to Expand Medicare Coverage of Telemedicine Again Print E-mail
Written by Vitale Health Law   
Tuesday, 18 April 2017 17:20

Congress is taking another crack at expanding Medicare coverage for services delivered via telemedicine. U.S. Senators Cory Gardner (R-CO) and Gary Peters (D-MI) recently introduced bipartisan legislation that would require the Center for Medicare and Medicaid Innovation (CMMI) to "test the effect of including telehealth services in Medicare health care delivery reform models." CMMI's role is to support the development and testing of innovative health care payment and service delivery models.

Dubbed, the Telehealth Innovation and Improvement Act, the bill is designed to expand access to healthcare for rural patients who lack access to healthcare. Currently, Medicare covers limited telehealth services, "setting a poor industry standard, discouraging innovation, and restricting access to specialized services," according to a news release issued by Gardner's office.

In addition to testing, the bill would direct CMMI to have an independent evaluation conducted to assess the telehealth models for cost, effectiveness, and improvement in quality of care without increasing the cost of delivery. If the telehealth model meets these criteria, then the model would be covered through the Medicare program.

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Last Updated on Tuesday, 09 May 2017 17:04
HHS's Price Urges Doctors to Submit Ideas for Medicare Pay Models Print E-mail
Written by FHI's Week in Review   
Monday, 17 April 2017 16:50

Mindy Yochelson reports via Bloomberg BNA:

Doctors should step up and recommend more payment alternatives to fee-for-service Medicare, the HHS secretary said April 11.

Doctors across the country should offer the committee ideas about what payment model would work better for them, the HHS secretary said. This is especially important for those in rural and underserved areas who think the current system is designed for large integrated groups that have administrative assistance, he said.

Read more in the current issue of Week in Review>>

Last Updated on Monday, 17 April 2017 16:56
CMS to launch national campaign to promote coordinated-care program Print E-mail
Written by FHI's Week in Review   
Monday, 20 March 2017 18:35

Virgil Dickson, in a March 14, 2017 Modern Healthcare post, reports:

Doctors may be unknowingly forgoing hundreds of millions in federal funding that would compensate them to better care for the sickest Medicare beneficiaries, and the CMS is launching a national campaign Wednesday to encourage physicians to take advantage of the funds.

Read more in the current issue of Week in Review>>

Last Updated on Monday, 20 March 2017 18:39
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