NEW: We are pleased to share the 2nd Annual Report from NORC’s independent evaluation of the CMS Global and Professional Direct Contracting (GPDC) Model (now, the ACO REACH model) for Centers for Medicare & Medicaid Services . This evaluation focuses on CMS’s investment in accountable care organizations (ACOs) and ongoing testing of ACOs and other approaches to care-delivery transformation within the Medicare program. Read the report and learn more about NORC’s work on this project: https://lnkd.in/eXhi3HPw
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Key findings frm the 2023 APM Measurement Report include: · New accountable care measurement showing over 93 million Americans are in an accountable care arrangements. · Payers across all lines of business (Commercial, Traditional Medicare, Medicare Advantage, Medicaid) are increasingly investing in value-based care models where providers share in the savings and the losses. · 72% of payers surveyed believe that APM activity will increase in the future. Get the full report: https://bit.ly/23APM
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Key findings from the 2023 APM Measurement Report include: · New accountable care measurement showing over 93 million Americans are in an accountable care arrangements. · Payers across all lines of business (Commercial, Traditional Medicare, Medicare Advantage, Medicaid) are increasingly investing in value-based care models where providers share in the savings and the losses. · 72% of payers surveyed believe that APM activity will increase in the future. Get the full report: https://bit.ly/23APM
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In a study of the production of clinical notes after the 2021 changes to the Centers for Medicare and Medicaid Services' evaluation and management CPT billing codes, “providers generally reduced their average time of 5.4 minutes spent on each note to 4.8 minutes per note”: https://lnkd.in/dvUpCnm8
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The Centers for Medicare & Medicaid Services (CMS) recently published revisions to ICD-10-CM Official Guidelines for Coding and Reporting for fiscal year (FY) 2024, effective Oct. 1, 2023, through Sept. 30, 2024. These changes include: 395 new codes 22 code revisions 25 deletions. Carefully review FY 2024 guideline updates as they can impact appropriate coding and billing practices. This information is accessible on our MGMA website. #MGMA
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Legal Update: CMS Status Update on Advanced Explanation of Benefits Implementation On April 23, 2024, the Centers for Medicare and Medicaid Services (CMS) provided a status update on the progress it is making toward implementation of the advanced explanation of benefits (AEOB) transparency provision of the Consolidated Appropriations Act (CAA). While the AEOB requirement was originally effective in 2022, federal agencies delayed the requirement for plans and issuers to provide AEOBs until implementation rules could be issued. Click here to learn more and download this Legal Update (https://buff.ly/3QsG3lA) https://buff.ly/4djkg9I
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CMS announced that the Medicare Shared Savings Program (#MSSP) has saved a net $1.8 billion in 2022 for accountable care organizations, which is the second-highest annual savings since the program began 10 years ago. It is also the sixth consecutive year the program has generated savings. https://lnkd.in/dHcgKi8f The experimentation over the last decade has demonstrated the incremental success of #ACOs. Now is the time to move towards a more explosive impact trajectory for #valuebasedcare. The #racetovalue is one of the biggest challenges of our generation and will require us to realign financial incentives in #healthcare and make it more affordable, efficient, high quality, and equitable.
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On 3 May, the Centers for Medicare & Medicaid Services issued draft guidance for initial price applicability year 2027 of the Drug Price Negotiation Program established by the IRA. Read our insights here. https://lnkd.in/ehBqZyN9 #IRA #drugpricing
CMS Issues Draft Guidance on Inflation Reduction Act (IRA) Drug Price Negotiation Program for 2027
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The Centers for Medicare & Medicaid Services (CMS) have announced key changes for 2025. These updates, which affect Part D of the drug benefit program, are crucial for anyone involved with Medicaid, Medicare, and CHIP. To understand these regulatory requirements and their impact, head over to our blog for more details! https://bit.ly/3RJdbWF
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📢 Impressive Results for ACOs in 2022! 🌟 Total earned performance payments reached $2.52 billion, with 63% of ACOs sharing savings. Low revenue ACOs achieved $140 per capita net savings, led by 75% primary care clinicians. The National Association of ACOs advocates for extending incentives through the Value in Health Care Act, supported by $21 billion Medicare savings in the last decade. CMS highlights ACOs' superior quality performance, while a new fee schedule proposes enhancing MSSP for rural and underserved providers. Share your thoughts by Sept. 11! #ACOsuccess #HealthcareInnovation 🏥💰📈
ACOs delivered bigger 2022 savings than in 2021: CMS
fiercehealthcare.com
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The Centers for Medicare & Medicaid Services (CMS) released draft guidelines of how it will approach the IRA for the medicines to be price-controlled in 2027, and the agency’s suggested rules raise more questions than they answer. CMS is still refusing to demand that PBMs ensure that savings are passed to patients, and plans for the administrative structure that will hold the whole program together financially – the Medicare Transaction Facilitator – still remain dangerously underdeveloped. Read more on their draft guidance here: https://lnkd.in/egmbvyb2
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