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November 9, 2017

ACO roundup: MACRA committee backs 2 physician-focused payment models

Daily Briefing
    • MACRA committee backs 2 physician-focused payment models. The Physician-Focused Payment Model Technical Advisory Committee, established under MACRA to advise HHS on physician-focused payment models, late last month recommended the agency implement two new programs for implementation and testing. First, the committee recommended the Hospital at Home Plus model, which aims to provide hospital-level acute care in home settings, because the program providers an alternative to hospital-based care and facilitates care coordination and integration. Second, the committee recommended the Oncology Bundled Payment Program Using CNA-Guided Care, a bundled payment model for some of the most common types of cancer. The committee said the oncology model should be combined with the ACS-Brandeis Advanced Alternative Payment Model, which focuses on more than 100 procedures and conditions, and rolled out for limited testing.

    • The United States can learn from other nations' 'frugal innovations,' study finds. The United States can learn from several "frugal innovations" pioneered in other nations that improved care quality at the same cost, maintained care quality while lowering costs, or did both, according to a new study in Health Affairs. For the study, the researchers assessed five innovations—implemented in Mexico, India, Kenya, Brazil, and Singapore—that altered care settings and providers, improved communication between providers and patients, focused on behaviors that can burden the health care system, and aimed to boost efficiency. According to the researchers, the programs' successes were linked to early funding, early buy-in from stakeholders, and routine self-assessment to get feedback from patients and providers. "The potential for successful uptake of each of these innovations in the United States is predicated on addressing potential regulatory, scope-of-practice, funding, governance, training, and delivery issues," the researchers said.

    • Your hospital's VBP penalty or bonus for 2018, mapped. Nearly 1,600 hospitals will receive bonus payments under the Value-Based Purchasing (VBP) Program in fiscal year (FY) 2018, CMS announced Friday. FY 2018 is the sixth year of the VBP Program, which adjusts Medicare inpatient reimbursements based on hospitals' performance on quality and patient experience measures. Overall, about half of the 2,808 hospitals participating in the program will receive a payment adjustment that ranges from a negative 0.5% to positive 0.5%. Specifically, about 57% of hospitals will see bonuses in FY 2018, up from 55% in FY 2017, while about 1,211 hospitals will face reductions in FY 2018, down from 1,343 in FY 2017, Modern Healthcare reports. 

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    • Medicare payment update final rule for hospital outpatient payments for CY 2018. Join us on Friday, Nov. 10, to discuss CMS' changes to hospital outpatient and ambulatory surgical center payments in CY 2018. We'll pay special attention to CMS' changes to outpatient total knee replacement, reducing drug reimbursement under the 340B program, reducing payments to certain nonexcepted outpatient providers, and much more.

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