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February 28, 2019

ACO roundup: To revamp primary care, Medicare plans to 'blow up' the office visit

Daily Briefing
    • To revamp primary care, Medicare plans to 'blow up' office visit. Earlier this month, Adam Boehler, director of the Center for Medicare and Medicaid Innovation, said he plans to "blow up" the current reimbursement system for primary care physicians by revamping the office visit. Boehler said CMMI is developing a new voluntary model for PCP payments that will be released in the coming weeks. Under the model, PCPs would be incentivized to keep patients at home and out of the hospital via telehealth, online consultations, and other methods.
    • AHA initiative explores hospitals' population health efforts. The American Hospital Association has launched the Hospital Community Cooperative, a yearlong initiative to assess 10 participating health systems' different approaches toward addressing social determinants of health, collect and share information, and establish a blueprint that other providers could eventually emulate. Each hospital involved in the initiative gets $10,000 in funding, technological support, and guidance from experts in the relevant field. Participating organizations include Parkland Health & Hospital System, University of Vermont Medical Center, Holy Name Medical Center, Multicare Health System, and more.
    • CMS will resume terminating low-performing MA, Part D plans. CMS in a memo sent earlier this month to Medicare Advantage (MA) and Medicare Part D insurers said it will resume its practice of terminating MA and Part D plans that consistently receive poor quality ratings. CMS had been prohibited from terminating such MA plans under a provision included in the 21st Century Cures Act. However, that provision expired Jan. 1, and CMS said it again could terminate plans that have failed to receive a summary quality rating of at least three stars for three consecutive years. The agency said it would follow similar guidelines for terminating Part D plans.

    From Advisory Board:

    • MACRA 201. Join us for 30 minutes on today, February 28, at 3:00 p.m. ET where we'll explain the complex MIPS policies and their intersection with the APM track.

    Register Here

    Register Here

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