Five Keys to Success Under the Oncology Care Model

In January 2016, the Centers for Medicare & Medicaid Services (CMS) and its Center for Medicare and Medicaid Innovation (CMMI) announced a new value-based payment program for oncology practices and centers. The Oncology Care Model (OCM) is an alternative payment model (APM) that CMS is testing over a 5-year period to evaluate the shift in oncology payments from fee-for-service to fee-for-value. Continue reading

AMCs, Teaching Hospitals Stand to Gain Under New CMS Model

This blog post was written by Michelle Wilkinson, Manager, and Emma Mandell Gray, Senior Manager.

Last month, the Centers for Medicare & Medicaid Services (CMS) announced a new initiative geared toward improving healthcare delivery. The Accountable Health Communities (AHC) model attempts to bridge a critical gap between clinical care and community and social services by screening Medicare and Medicaid beneficiaries for certain health-related social needs in the core areas of housing, food, utilities, interpersonal violence, and transportation. CMS’s goal is to ultimately improve overall care and health outcomes by steering patients to the appropriate community resources available to them. Continue reading

CMS Announces Final Rule for Joint Replacement Bundle Program

In a widely anticipated statement, the Centers for Medicare & Medicaid Services (CMS) announced on November 16, 2015, the publication of a final rule that will require certain hospitals to participate in a bundled payment program for lower extremity joint replacements. The Comprehensive Care for Joint Replacement (CJR) program is designed to incentivize hospitals and contracted collaborators to actively share in reducing cost variation for joint replacements while improving quality and outcomes. These common orthopedic procedures can range in cost from $16,500 to $33,000, as noted by the announcement, and offer a significant opportunity for savings through reduced variation in utilization and more consistent care management. Continue reading

Mandatory Bundled Payment: Getting into Formation for Value-Based Care

When the Centers for Medicare & Medicaid Services (CMS) launches the Comprehensive Care for Joint Replacement (CCJR) Model on January 1, 2016, it will signify one of the most dramatic steps toward transforming the way healthcare services are reimbursed across the U.S. healthcare system. The CCJR Model will be the first mandatory bundled payment initiative, and success under this new model will require collaboration – among hospitals, physicians, skilled nursing facilities, home health providers, and others. To learn more about the model and how your organization can thrive in this new environment, read John Fink’s article “Mandatory Bundled Payment: Getting into Formation for Value-Based Care” in the October issue of hfm Magazine.

Meaningful Use Stage 3: Quality Oasis or Technology Mirage?

A popular adage dictates that if something isn’t broken, you shouldn’t try to fix it. Chances are, no one has ever said that about the meaningful use program. On March 20, 2015, CMS released the proposed rule for Stage 3 of meaningful use. Now in its fifth year, the well-intentioned but controversial program is often criticized for being overly complicated, burdensome, and reliant on EHR technology not yet in production.  As we continue to sift through the new rule’s 300+ pages, two key questions come to mind:  Continue reading