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CMS Launches Largest-Ever Multi-Payer Initiative to Improve Primary Care in America

Policy Snapshot
Payment
April 15, 2016

On April 11, the Centers for Medicare & Medicaid Services (CMS) announced its largest-ever initiative to transform and improve how primary care is delivered and paid for in America. The Comprehensive Primary Care Plus (CPC+) model, will be implemented in up to 20 regions and can accommodate up to 5,000 practices. The initiative is designed to provide doctors the freedom to care for their patients the way they think will deliver the best outcomes and to pay them for achieving results and improving care.

Primary care practices will participate in one of two tracks. Both tracks...

2016 eCQMs Annual Update Available

Policy Snapshot
Payment, Practice Management
April 15, 2016

The Centers for Medicare & Medicaid Services (CMS) posted the 2016 Electronic Clinical Quality Measures (eCQMs) annual update for eligible hospitals and eligible professionals to electronically report 2017 quality data for CMS quality reporting programs. Visit the eCQM Library or Electronic Clinical Quality Improvement Resource Center websites for information on how to download the measures. This year’s...

CMS Medicare Shared Savings Program ACO Application Process Call — Last Chance to Register

Policy Snapshot
Payment, Accountable Care Organization (ACO)
April 15, 2016

Tuesday, April 19 from 1:30 to 3 pm ET

To Register: Visit MLN Connects Event Registration. Space may be limited, register early.

During this call, Centers for Medicare & Medicaid Services (CMS) subject matter experts will cover helpful tips to complete a successful application for the Medicare Shared Savings Program (Shared Savings Program). A question and answer session will follow the presentation.

We encourage call participants to review important information, dates, and materials on the...

Open Payments: Physician and Teaching Hospital Review and Dispute Period Began April 1

Policy Snapshot
Payment, Attending Physician
April 8, 2016

Review and dispute for Open Payments data began April 1 and will last for 45 days. The Centers for Medicare & Medicaid Services (CMS) will publish the 2015 payment data and updates to the 2013 and 2014 data on June 30, 2016.

Physicians and teaching hospitals must initiate any disputes during the review period. Review and dispute is voluntary but strongly encouraged. If you have never registered in the Open Payments system, initial registration is a two-step process and should only take 30 minutes. See the...

2015 Mid-Year QRURs Available

Policy Snapshot
Centers for Medicare and Medicaid (CMS), Payment, Attending Physician
April 8, 2016

The Centers for Medicare & Medicaid Services (CMS) released the 2015 Mid-Year Quality and Resource Use Reports (MYQRURs) to groups and solo practitioners nationwide. MYQRURs are for informational purposes only and will not affect your payments under the Medicare Physician Fee Schedule. For more information, visit the 2015 QRUR and 2017 Value Modifier webpage. See the...

IMPACT Act: Data Element Library Call with CMS— Last Chance to Register

Policy Snapshot
Skilled Nursing Care, Centers for Medicare and Medicaid (CMS), Attending Physician, Nurse Practitioner (NP), Physician Assistant (PA)
April 8, 2016

Thursday, April 14 from 2 to 3 pm ET

To Register: Visit MLN Connects Event Registration. Space may be limited, register early.

During this call, Centers for Medicare & Medicaid Services (CMS) subject matter experts discuss the development of the Data Element Library.

A question and answer session will follow the presentation, including an opportunity for registrants to provide feedback on the Library. The...

Learn More About ACOs with Two New Fact Sheets from CMS

Policy Snapshot
Centers for Medicare and Medicaid (CMS), Accountable Care Organization (ACO), Nurse Practitioner (NP), Physician Assistant (PA)
April 8, 2016

A revised Accountable Care Organizations: What Providers Need to Know Fact Sheet is available. Learn about: 

  • Participating in the Medicare Shared Savings Program
  • Coordinating care through Accountable Care Organizations (ACOs)
  • Satisfying the quality performance standards

And a revised...

New Research Confirms Looming Physician Shortage

Policy Snapshot
Attending Physician
April 8, 2016

Shortages Particularly Acute in Specialties Most Needed by an Aging Population

Under every combination of scenarios modeled, the United States will face a shortage of physicians over the next decade, according to a physician workforce report released this week by the AAMC (Association of American Medical Colleges). The projections show a shortage ranging between 61,700 and 94,700, with a significant shortage showing among many surgical specialties...

CMS Launches New Effort to Improve Care for Nursing Facility Residents

Policy Snapshot
Long-Term Care, Skilled Nursing Care, Centers for Medicare and Medicaid (CMS), Payment, Attending Physician, Medical Director, Nurse Practitioner (NP), Physician Assistant (PA), Quality
April 1, 2016

The Centers for Medicare & Medicaid Services (CMS) today announced it will test whether a new payment model for nursing facilities and practitioners will further reduce avoidable hospitalizations, lower combined Medicare and Medicaid spending, and improve the quality of care received by nursing facility residents.

This next phase of the Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents seeks to reduce avoidable hospitalizations among beneficiaries eligible for Medicare and/or Medicaid by providing new payments to practitioners for...

CMS: You can bill CCM in Non-Part A Nursing Facility Stays

Policy Snapshot
Assisted Living, Skilled Nursing Care, Centers for Medicare and Medicaid (CMS), Payment, Current Procedural Terminology (CPT) codes, Attending Physician, Nurse Practitioner (NP), Physician Assistant (PA)
April 1, 2016

Over the last year, AMDA - The Society for Post-Acute and Long-Term Care Medicine has asked the Centers for Medicare & Medicaid Services (CMS) to clarify whether the Chronic Care Management (CCM) Current Procedural Terminology (CPT) code was billable in nursing facilities. The original descriptor per AMA CPT for CCM stated that “these [CCM] management and support services are provided to patients who reside at home or in a domiciliary, rest home, or assisted living facility” which left confusion about billing the code in skilled nursing facility and nursing facility (SNF/NF) settings....