Payment Models/Reimbursement
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Participants Earned $484 Million Under GPDC Model, CMS Saved $371 Million
Model results are in for the direct contracting program. CMS had a net savings of $372 million while model participant net savings were $484 million, all while maintaining high quality. Read our blog for more results and for details on how its successor, ACO REACH, will be changing in future years.
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Making Care Primary Model Details
The federal Making Care Primary model is now accepting applications but only through November 30. Interested in learning more or applying? You’ll want to read on for details.
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Emerging Options for Health Care in Rural and Underserved Communities
Access to care can be difficult in some rural and underserved communities. We highlight some opportunities to consider to help bridge these gaps. From mobile health units and telehealth to Rural Emergency Hospitals and innovative partnerships, make sure to read on for more insights.
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Dementia Care Model Announced
Better care for those with dementia and their caregivers is the goal of the new Medicare GUIDE model. The newly released model is an opportunity for physicians, home health, assisted living facilities, ACO REACH, shared savings ACOs and more. Read on for details.
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New Opportunities For FQHCs, Rural Health Clinics
From behavioral health policies to telehealth and care management codes, there are new opportunities emerging for federally qualified health centers and rural health clinics. You’ll want to read on for details.
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Making Care Primary: A Run-Down on CMMI’s Newest Value Model
Primary care is a lynchpin to patient wellness as well as a foundational element to value-based payment approaches. The newest primary care model — Making Care Primary — was recently announced by the CMS Innovation Center. It offers three different tracks, six different payments and an opportunity for primary care practices, including FQHCs, to start or continue their value-based journey.
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Congress Turning Attention on Hospitals
Even though hospitals and health systems may still be recovering from various pandemic-related impacts, that is not stopping Congress from looking into key issues. We provide our outlook on four of those focus areas — site neutral payments, price transparency, 340B and consolidation — and then what you can do about them.
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Minimum Data Set Changes Coming in October – Are You Ready?
Big changes are coming to skilled nursing facilities in October related to the minimum data set. Learn more in today’s blog and reach out if CLA can assist.
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Impacts on Health Care With a Debt Ceiling Breach?
Early June sets up a potential debt ceiling breach unless Congress and the President can quickly come to agreement. What issues are holding up negotiations, and how could health care be impacted? Read on.
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All Skilled Nursing Facilities Face MAC-Probe and Educate Review Starting June 5
Medicare’s projected improper payment rate for skilled nursing facilities is far too high for CMS, prompting the agency to mandate MACs perform a 5-claim probe and educate review on all SNFs. Read on for details plus information on improper rates for other settings.