Medicare

• Pathways to Success: MSSP proposed rule: Integrity

  By Jason Karcher, Brian A. Sweatman | 01 November 2018

  This paper discusses ways in which accountable care organizations have been identified by the Centers for Medicare and Medicaid Services (CMS) as weakening integrity and how CMS is proposing to address concerns.

• Pathways to Success: MSSP proposed rule: Assignment changes to identification of E&M Services in skilled nursing facilities

  By Anders Larson, Jill S. Herbold | 19 October 2018

  This paper discusses the current and proposed rules related to evaluation and management services in the Medicare Shared Savings Program.

• 2019 cost-of-living adjustments for Medicare benefits

  By Milliman Employee Benefits Research Group | 17 October 2018

  CAB 18-3: The Department of Health and Human Services’ Centers for Medicare and Medicaid Services has announced cost-of-living adjusted figures for Medicare Part A and Part B for 2019.

• Population-based payments (PBPs) open door for ACOs to more effectively manage care

  By Noah Champagne, Jason McEwen | 16 October 2018

  The Next Generation accountable care organization (ACO) model introduced a provider payment mechanism called population-based payments that allow ACOs to negotiate provider payment rates and may allow more effective management of resource use.

• Impact of Next Generation ACO Model on Medicare spending in 2016

  By Hugh Larson, Annie Man, Timothy J. Wilder, Coleen Young | 15 October 2018

  This paper combines the aggregate gross impact of each of the Next Generation Accountable Care Organizations (NGACOs) shown in the NORC report with the shared savings/(loss) results of each NGACO to calculate the net impact of each individual NGACO.

• Pathways to Success: MSSP proposed rule: Winners and losers

  By Anders Larson, Cory Gusland | 03 October 2018

  All accountable care organizations (ACOs) will be affected by the Medicare Shared Savings Program if enacted, and the impact of the rule change will vary by ACO depending on its current situation and unique characteristics.

• Pathways to Success: MSSP proposed rule: Beneficiary incentive program

  By Carol Bazell, Susan Philip, Laurie Lingefelt | 26 September 2018

  This paper explores the beneficiary incentive program proposed in the Medicare Shared Savings Program.

• Opportunities for care coordination through innovative technologies

  By Susan Philip, Carol Bazell, Laurie Lingefelt | 24 September 2018

  This paper discusses how accountable care organizations (ACOs) can increase their use of telehealth and other innovative non-face-to-face services in response to opportunities arising from new CMS policies and/or environmental changes.

• Preference-sensitive surgical procedures for preference-sensitive conditions

  By Kathryn V. Fitch, Carol Bazell, Sumudu Dehipawala | 24 September 2018

  This paper focuses on 15 preference-sensitive surgical procedures that may be performed to treat certain preference-sensitive conditions that have surgical treatment options.

• Pathways to Success MSSP proposed rule: Beneficiary assignment

  By Colleen Norris, Jason McEwen, Jonah Broulette | 07 September 2018

  This paper describes how the impact of the rule change will vary by ACO depending on its current situation and unique characteristics and examines the rule from the perspective of different ACO situations.

See More Articles