March 29, 2018

ACO roundup: Providers tell MedPAC, 'Change MIPS, don't scrap it'

Daily Briefing
    • Providers push back on MedPAC recommendation, calling for change instead of repeal. Hospital and provider groups are largely pushing back against a recommendation from the Medicare Payment Advisory Commission (MedPAC) that Congress repeal MACRA's Merit-based Incentive Payment System (MIPS) program and replace it with a voluntary value program (VVP), Rod Moore reports for HFMA. The stakeholders say it's premature to scrap MIPS entirely, but generally agree that Congress should change the program to ease reporting requirements.

    • Federal advisory panel recommends Medicare test end-of-life APMs. The Physician-Focused Payment Model Technical Advisory Committee (PTAC) on Monday recommended HHS pursue two alternative payment models for Medicare beneficiaries seeking palliative care. According to Modern Healthcare's Virgil Dickson, both models—the Patient and Caregiver Support for Serious Illness, and the Advanced Care Model Service Delivery and Advanced Alternative Payment Model—would require medical providers and spiritual care providers to coordinate care under an incentivized payment structure to develop and implement for eligible beneficiaries. PTAC added that the proposed models could eventually be merged into one program.

    • At least 17 states could be exempt from Medicaid's network adequacy rule. CMS last week issued a proposed rule that would exempt some states from requirements to assess whether fee-for-service Medicaid beneficiaries can easily access certain health care services. CMS in 2015 finalized a rule that standardized the process for states to document whether their provider networks meet access to care requirements for various health care services. However, last week, CMS proposed exempting states from the access to care reporting requirements if at least 85% of their Medicaid populations are enrolled in managed care plans—a change that if approved would apply to about 17 states, according to the agency. CMS also proposed a change that would make additional states eligible for an exemption.

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