Tag Archives: coordination of care

CMS Invites Comments on Ways to Ease the Burden of Stark Physician Self-Referral Rules on Coordinated Care Arrangements

As part of its “Regulatory Sprint to Coordinated Care,” the Centers for Medicare & Medicaid Services (CMS) is seeking input on how it can address “unnecessary obstacles to coordinated care, real or perceived, caused by the physician self-referral law.” CMS Administrator Seema Verma acknowledged in a recent blog post that “[i]n its current form, the … Continue Reading

Proposed Revisions to Home Health Conditions of Participation

On October 9, 2014, CMS is publishing a proposed rule that would extensively revise the conditions of participation (CoPs) that home health agencies (HHAs) must meet to participate in the Medicare and Medicaid programs. The rule is intended to provide HHAs with enhanced flexibility while focusing provider efforts on the services delivered to the patient, the … Continue Reading

CMS Call: Medicare Shared Savings Program and Advance Payment Model Application Process (July 31)

On July 31, CMS is hosting a call on the Medicare Shared Savings Program application and Advance Payment Model application processes for the January 1, 2013 Shared Savings Program start date. These two initiatives are designed to help providers participate in Accountable Care Organizations (ACOs) to improve quality of care for Medicare patients. Registration is … Continue Reading

CMS Guidance on Medicaid Integrated Care Models

On July 10, 2012, CMS released two letters to state Medicaid agencies on “Developing and Implementing Integrated Care Models in Medicaid Programs.” The first letter describes the concept of “Integrated Care Models,” which could include medical/health homes, accountable care organizations (ACOs), ACO-like models, and other arrangements that emphasize person-centered, continuous, coordinated, and comprehensive care. The … Continue Reading

CMS Call on Medicare Shared Savings Program and Advance Payment Model Application Process (July 16)

On July 16, 2012, CMS is hosting a National Provider Call on the Shared Savings Program application and Advance Payment Model application processes  for the January 1, 2013 Shared Savings Program start date. These two initiatives are designed to help providers participate in Accountable Care Organizations (ACOs) to improve quality of care for Medicare patients. … Continue Reading

MedPAC Examines Medicare Benefit Redesign, Dual Eligible Policy Options

On June 15, 2012, MedPAC released its June 2012 Report to the Congress on “Medicare and the Health Care Delivery System.”  Unlike most MedPAC reports that focus on provider payments, this report examines the role of beneficiaries and their impact on the Medicare program. In particular, MedPAC recommends reforms to Medicare’s benefit design/cost-sharing structure to … Continue Reading

CMS Announces Comprehensive Primary Care (CPC) Initiative Participants

On June 6, 2012, the CMS Innovation Center announced that 45 insurers in seven markets will participate in the CPC Initiative, under which CMS will offer bonus payments to primary care doctors who improve patient care coordination. CMS will select approximately 75 primary care practices in each designated market to participate. Interested primary care practices … Continue Reading

GAO Report on Impact of Fraud and Abuse Laws on Medicare Financial Incentive Programs

A recent GAO report focuses on how federal fraud and abuse laws affect the implementation of financial incentive programs intended to improve quality and efficiency, such as pay-for-performance programs that reward physicians for adherence to clinical protocols or shared savings programs that offer physicians a percentage of a hospital’s cost savings attributable to the physicians. … Continue Reading

CMS Initiative Targets Avoidable Nursing Facility Resident Hospitalization

CMS has launched the “Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents,” through which the agency will partner with independent organizations to improve care for long-stay nursing facility residents enrolled in Medicare and Medicaid. CMS will support organizations (called “enhanced care & coordination providers”) that work with nursing facilities to implement evidence-based interventions to … Continue Reading

HHS Health IT Challenge Targets Post-Discharge Care

The HHS National Coordinator for Health Information Technology has announced a “Discharge Follow-Up Appointment” care transitions challenge for health IT software developers, the second “Investing in Innovation” (i2) Initiative. The challenge seeks to stimulate the use of simple, information technology-enabled processes to schedule follow-up appointments and post-discharge testing before a patient leaves the hospital, thereby … Continue Reading

CMS Call on ACA Comprehensive Primary Care Initiative (Oct. 13)

On October 13, 2011, CMS is hosting a call to discuss its request for applications for the Comprehensive Primary Care (CPC) initiative, which is designed to help primary care practices deliver higher quality, better coordinated, and more patient-centered care. The call will begin at 1:00 p.m. ET; to participate, dial 1-800-837-1935 and reference Conference ID … Continue Reading

CMS Invites Applications for New Comprehensive Primary Care Initiative

On September 28, 2011, CMS announced a new “Comprehensive Primary Care” (CPC) initiative, designed to help primary care practices deliver higher quality, better coordinated, and more patient-centered care. The program is being established under section 3021 of the ACA, which authorized CMS to test innovative payment and service delivery models that reduce spending under Medicare, … Continue Reading

HHS Launches “Safe Transitions from Hospital to Home” Software Challenge

HHS has launched the “Ensuring Safe Transitions from Hospital to Home” challenge, which will award cash prizes of up to $25,000 to software developers who create technology solutions that help discharged patients take charge of their health care during transitions of places of care. According to an HHS notice, innovative applications will help patients and their … Continue Reading
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