Mercy Health’s Post

The Centers for Medicare & Medicaid Services announced that next year, they will launch the ACO Primary Care Flex Model, a five-year voluntary model that will target and support smaller, lower revenue ACOs. There are several goals of this program, one of which is to increase participation in MSSP, which has slowed over the last few years. #MSSP #valuebasedcare #ACO #accountablecareorganization

On January 29th, the Centers for Medicare & Medicaid Services (CMS) reported an increased participation in its Accountable Care Organization (ACO) initiatives for 2024. Among the updates, CMS revealed the participation of 19 newly established ACOs in the Medicare Shared Savings Program that will engage in a new, permanent payment option in 2024. This initiative allows these ACOs to receive over $20 million in advance investment payments (AIPs) specifically for caring for underserved populations. 50 new ACOs have joined the program in 2024, with 71 renewing their participation, bringing the total number of ACOs participating in the Shared Savings Program to 480. This program is the largest ACO initiative in the nation. Learn more about this growing participation and what it means. https://bit.ly/4aXKkp5

"On Jan. 1, 2025, the U.S. Center for Medicare & Medicaid Services' (CMS) Innovation Center will begin implementing a payment model for primary care known as the Accountable Care Organizations (ACOs) Primary Care Flex Model under the Medicare Shared Savings Program (MSSP)." Learn more about ACO Flex Model: https://lnkd.in/e64VwZ7y

On July 30, 2024, the Centers for Medicare & Medicaid Services (CMS) issued a final rule (CMS-1810-F) updating Medicare hospice payment rates and the aggregate cap amount, for fiscal year (FY) 2025, in accordance with existing statutory and regulatory requirements. This rule also finalizes the proposal to adopt the most recent Office of Management and Budget (OMB) statistical area delineations, which impacts the hospice wage index and clarifies current policy related to the hospice “election statement” and the “notice of election” (NOE), as well as adds clarifying language regarding hospice admission and certification of terminal illness. The final rule summarizes public comments received related to the request for information regarding implementing a separate payment mechanism to account for high-intensity palliative care services. This rule also finalizes that Hospice Quality Reporting Program (HQRP) measures be collected through a new collection instrument, the Hospice Outcomes and Patient Evaluation (HOPE), and finalizes two HOPE-based measures and discusses the anticipated trajectory for future refinement. The rule summarizes public comments received on the request for information regarding potential social determinants of health (SDOH) elements and provides updates on health equity, future quality measures (QMs), and public reporting requirements. Finally, the rule makes changes to the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Survey. Medicare Hospice Payment Policies FY 2025 Routine Annual Rate Setting Changes Hospice Quality Reporting Program (HQRP) Hospice Conditions of Participation (CoPs) and Payment Requirements Technical Updates

Making Care Primary (MCP) Model On June 8, 2023, the Centers for Medicare & Medicaid Services (CMS) announced a new voluntary primary care model – the Making Care Primary (MCP) Model – that will be tested in eight states. Launching July 1, 2024, the 10.5-year model will improve care management and care coordination, equip primary care clinicians with tools to form partnerships with health care specialists, and leverage community-based connections to address patients’ health needs as well as their health-related social needs (HRSNs) such as housing and nutrition. CMS is working with State Medicaid Agencies in eight states – Colorado, North Carolina, New Jersey, New Mexico, New York, Minnesota, Massachusetts and Washington – to engage in full care transformation across payers, with plans to engage private payers in the coming months. https://buff.ly/465Lf5B

Making Care Primary (MCP) Model On June 8, 2023, the Centers for Medicare & Medicaid Services (CMS) announced a new voluntary primary care model – the Making Care Primary (MCP) Model – that will be tested in eight states. Launching July 1, 2024, the 10.5-year model will improve care management and care coordination, equip primary care clinicians with tools to form partnerships with health care specialists, and leverage community-based connections to address patients’ health needs as well as their health-related social needs (HRSNs) such as housing and nutrition. CMS is working with State Medicaid Agencies in eight states – Colorado, North Carolina, New Jersey, New Mexico, New York, Minnesota, Massachusetts and Washington – to engage in full care transformation across payers, with plans to engage private payers in the coming months. https://buff.ly/465Lf5B

Making Care Primary (MCP) Model On June 8, 2023, the Centers for Medicare & Medicaid Services (CMS) announced a new voluntary primary care model – the Making Care Primary (MCP) Model – that will be tested in eight states. Launching July 1, 2024, the 10.5-year model will improve care management and care coordination, equip primary care clinicians with tools to form partnerships with health care specialists, and leverage community-based connections to address patients’ health needs as well as their health-related social needs (HRSNs) such as housing and nutrition. CMS is working with State Medicaid Agencies in eight states – Colorado, North Carolina, New Jersey, New Mexico, New York, Minnesota, Massachusetts and Washington – to engage in full care transformation across payers, with plans to engage private payers in the coming months. https://buff.ly/465Lf5B

States are increasingly contracting with D-SNPs to improve care delivery for people who are dually eligible for both Medicare and Medicaid. For Medicaid officials actively working with D-SNPs, or considering how best to contract with these entities, it’s essential to understand how the Medicare Advantage program works. CHCS’ Medicare Advantage Policy Basics training series can support Medicaid and partner agencies as they build needed Medicare capacity. Training modules cover: (1) contracting and bid development; (2) payment policy and rate setting; (3) supplemental benefits; and (4) the Star Rating system. Each module explores foundational Medicare knowledge, select policy and program design opportunities, features of Medicare Advantage that matter for Medicaid agencies, and resources available for states. The training series is made possible through support from Arnold Ventures, The Commonwealth Fund, and The SCAN Foundation. https://bit.ly/3ScXXK8   Alexandra Kruse; Lida Momeni; Valerie Flores, MGS; Nancy Archibald

The Centers for Medicare & Medicaid Services (CMS) is now accepting applications for the ACO Primary Care Flex Model. Organizations interested in participating must first apply — either as new ACOs or renewing ACOs — to the Shared Savings Program. The deadline to submit an application to the Shared Savings Program is June 17, 2024. Applicant ACOs must submit a supplemental ACO PC Flex application questionnaire by August 1, 2024. This new model introduces innovative payment structures for low revenue ACOs within the Shared Savings Program. It includes an Advance Shared Savings Payment to support ACO setup costs and administrative expenses, as well as the Prospective Primary Care Payment (PPCP) consisting of a County Base Rate and Enhanced Amount(s) based on ACO characteristics and patient population. CMS will reveal the selected participants in October 2024. The official launch of the ACO PC Flex Model is scheduled for January 1, 2025, and will span five years. For more details and to access the application, visit: https://lnkd.in/gv9sSUZ9

Making Care Primary (MCP) Model On June 8, 2023, the Centers for Medicare & Medicaid Services (CMS) announced a new voluntary primary care model – the Making Care Primary (MCP) Model – that will be tested in eight states. Launching July 1, 2024, the 10.5-year model will improve care management and care coordination, equip primary care clinicians with tools to form partnerships with health care specialists, and leverage community-based connections to address patients’ health needs as well as their health-related social needs (HRSNs) such as housing and nutrition. CMS is working with State Medicaid Agencies in eight states – Colorado, North Carolina, New Jersey, New Mexico, New York, Minnesota, Massachusetts and Washington – to engage in full care transformation across payers, with plans to engage private payers in the coming months. https://lnkd.in/ggJmM7Ku