C. Frederick Geilfuss II on Alternative Payment Models (APM)

Proposed Overhaul to the Medicare Shared Savings Program Would Mean More Risk for ACOs

On August 9, 2018, CMS introduced a proposed rule that would substantially overhaul the Medicare Shared Savings Program (MSSP), requiring Accountable Care Organizations (ACOs) that participate in the MSSP to accept some...more

8/21/2018 / ACOs , Alternative Payment Models (APM) , Centers for Medicare & Medicaid Services (CMS) , Medicare , Medicare Shared Savings Program , Physicians , Proposed Rules

New Demonstration Program Would Reward Clinicians for Accepting Risk in Medicare Advantage

CMS recently announced that it wants to launch a new demonstration program, the Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) Demonstration. If approved and adopted as a demonstration project, the MAQI...more

7/12/2018 / Alternative Payment Models (APM) , Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Healthcare , Medicare , Medicare Access and CHIP Reauthorization (MACRA) , MIPS , Physician Medicare Reimbursements , Physicians , Public Comment

Direct Provider Contract Alternative Payment Model - CMS/CMMI Issues Request for Information

On April 23, 2018, the Center for Medicare and Medicaid Innovation issued a Request for Information (the RFI) on a direct provider contracting model for primary care. The RFI seeks input on how direct provider contracting...more

5/2/2018 / Alternative Payment Models (APM) , Beneficiaries , Centers for Medicare & Medicaid Services (CMS) , CMMI , Electronic Health Record Incentives , Health Care Providers , Medicare , Physician Payments , Request For Information

6 Key Takeaways for Providers on BPCI-Advanced (Value-Based Medicare Payment)

Despite some initial difficulty in gaining momentum, the use of value-based payment methodologies will likely increase across all provider niches. This change is partly a function of cost savings driven by margin compression...more

3/20/2018 / ACOs , Alternative Payment Models (APM) , BPCI , Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Financial Markets , Health Care Providers , Medicare Access and CHIP Reauthorization (MACRA) , Medicare Shared Savings Program , Skilled Nursing Facility

CMS Announces an Advanced Alternative Payment Model - BPCI Advanced

On January 9, 2018, The Centers for Medicare & Medicaid Services (CMS) announced a new voluntary bundled payment model program – Bundled Payment for Care Improvement Advanced (BPCI Advanced). The episode payment model, which...more

1/19/2018 / Alternative Payment Models (APM) , BPCI , Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Health Care Providers , Medicare Access and CHIP Reauthorization (MACRA) , Physicians

Mandatory Cardiac Episode Payment Program: CMS Proposes Cancellation

On August 15, 2017, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule (Proposed Rule) that, if finalized, would (1) reduce the number of Metropolitan Statistical Areas (MSAs) in which there is...more

9/1/2017 / Alternative Payment Models (APM) , Cardiac Episode Payment Program , CCJR , Centers for Medicare & Medicaid Services (CMS) , Intent to Cancel , Provider Payments , Trump Administration

CMS Announces Latest Alternative Payment Model - Comprehensive Primary Care Plus

Continuing in its efforts to promote alternative payment models, on April 11, 2016, CMS announced the Comprehensive Primary Care Plus (CPC+) model. CMS hopes to implement CPC+ in up to 20 regions, accommodating up to 5,000...more

4/22/2016 / Alternative Payment Models (APM) , Centers for Medicare & Medicaid Services (CMS) , Comprehensive Primary Care (CPC+) , Health Care Providers , Health Information Technologies , MPFS , Physicians

Top Three Reasons ACOs Should Use Telehealth and Telemedicine

Accountable Care Organizations (ACOs) can share costs of telehealth and remote patient monitoring services among their hospitals, providers/suppliers, and other ACO participants, according to federal regulations under the...more

11/3/2015 / ACOs , Alternative Payment Models (APM) , Centers for Medicare & Medicaid Services (CMS) , Fee-for-Service , Fraud and Abuse , Health Care Providers , Health Information Technologies , Healthcare , Healthcare Reform , Hospitals , Medicare , Medicare Shared Savings Program , OIG , Suppliers , Telehealth , Telemedicine , Value-Based Purchasing , Waivers

2014 Medicare ACO Results Released: CMS Asserts Success but Few ACOs Receive Payments

The Centers for Medicare and Medicaid Services (CMS) released, on August 25, 2015, the quality and financial performance results for Medicare Accountable Care Organizations for 2014. CMS touted that Medicare ACOs continued to...more

9/10/2015 / ACOs , Alternative Payment Models (APM) , Bundled Payments , Centers for Medicare & Medicaid Services (CMS) , Electronic Medical Records , Health Care Providers , Healthcare Costs , Medicare , Medicare Shared Savings Program , Physician Medicare Reimbursements , Quality of Care Standards

C. Frederick Geilfuss II

Foley & Lardner LLP

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