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January 24, 2019

ACO roundup: CMS unveils new Medicare Part D payment model, updates MA model

Daily Briefing
    • MedPAC recommends overhaul for Medicare quality programs. The Medicare Payment Advisory Commission (MedPAC) last week said Congress should pass legislation that would consolidate Medicare's hospital quality initiatives on readmissions, value-based purchasing, and hospital-acquired conditions into one program, called the Hospital Value Incentive Program (HVIP), and increase payments to hospitals that perform well. According to the recommendations, HVIP, which would launch in 2020, would tie Medicare payments to the level of care quality hospitals provide. The program would also increase the payment rate by 2% in 2020, with hospitals contributing that funding back into the program for redistribution to the highest-performing hospitals. Overall, according to MedPAC, the suggested changes would increase spending on quality improvement programs over the next decade from $5 billion to $10 billion.
    • CMS unveils new Medicare Part D payment model, updates MA model. CMS on Friday unveiled updates to its value-based insurance design (VBID) model for Medicare Advantage (MA), as well as a new payment model for Medicare Part D plans. CMS said beginning in January 2020, the VBID model—which is currently available to MA plan insurers in 25 states—will be available to MA plan insurers in all 50 states, and participating plans will be able to test several new interventions, including expanded telehealth services, increased rewards and incentives, and targeted benefit designs. Meanwhile, the new Medicare Part D model, called the Part D Payment Modernization model, is a voluntary, five-year model that aims to address high costs under Medicare's catastrophic prescription drug coverage by requiring participating Part D plans to assume more financial risk when a beneficiary reaches the catastrophic phase.
    • How Kaiser Permanente is investing its $200M to fight homelessness. Kaiser Permanente last week revealed the first steps of its $200 million plan to reduce homelessness and increase affordable housing—the largest investment a private health care company has made to address the social determinants of health. According to Kaiser Permanente CEO Bernard Tyson said the first three targets of the initiative would include renovating an apartment complex to house more than 500 homeless Oakland residents who are ages 50 and older and who have one or more chronic conditions, preserving a 41-unit affordable housing complex in Oakland, and investing $100 million into a fund into a fund that will offer low-interest loans to preserve affordable housing for individuals in the eight states where Kaiser provides services, as well as the District of Columbia.

    From Advisory Board:

    • MACRA 101. Join us for 30 minutes on Thursday, January 31, at 3:00 p.m. ET where we'll break down MACRA's origins and provide an introduction to the two Quality Payment Program (QPP) tracks: the Merit-Based Incentive Payment System (MIPS) and the Advanced Alternative Payment Model (APM).

    Register Here

    Register Here

    Register Here

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