News & Analysis as of

Value-Based Purchasing Healthcare

Proskauer - Health Care Law Brief

CMS releases guidance on Expanded Home Health Value-Based Purchasing (“HHVBP”) Model

On November 2, 2021, the Centers for Medicare & Medicaid Services (“CMS”) issued a final rule (“Final Rule”) that advances the shift from paying for Medicare home health services based on volume to a system that pays based on...more

King & Spalding

CMS Issues Final Rule Affecting Home Health, Hospice, Inpatient Rehabilitation Facilities, and Long-Term Care Facilities for CY...

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On November 2, 2021, CMS put on display its final rule that, among other things, updates the home health and home infusion therapy services payment rates for calendar year (CY) 2022; makes significant changes to the provider...more

Smith Anderson

The ACO Specialist Manual

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The ACO Specialist Manual is a strategic guide to getting the optimum value-add contributions from each medical specialty in integrated health care. For purposes of this Manual, the teams are generally termed accountable care...more

Foley & Lardner LLP

Top Three Reasons ACOs Should Use Telehealth and Telemedicine

Foley & Lardner LLP on

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

BakerHostetler

The Deeper Dive: Medicare’s Fundamental Shift Toward P4P - What priorities should providers focus on in navigating the changing...

BakerHostetler on

While Medicare’s path toward pay for performance (P4P) has evolved over time, 2015 is proving to be a landmark year. July marked the 50th anniversary of the Medicare program. And in self-described “historic announcements”...more

Manatt, Phelps & Phillips, LLP

Manatt on Medicaid: Medicaid at 50—The Program’s Evolution and Future

Editor’s note: Born as an afterthought to Medicare five decades ago, Medicaid has evolved from an adjunct to state welfare programs into the nation’s largest health insurer. Medicaid’s 50th birthday is a fitting time to...more

Foley & Lardner LLP

Highlights from the Tenth CEO/Innovators Roundtable: June 4 – 5, 2015

Foley & Lardner LLP on

This past June, leaders from health systems, outpatient services companies, health insurers, IT and equipment suppliers, health retailers, home care providers, pharmaceutical companies, and investors gathered in Chicago for...more

King & Spalding

CMS Announces New Value-Based Insurance Design Model for Medicare Advantage

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On September 1, 2015, CMS unveiled a new Medicare Advantage Value-Based Insurance Design (MA-VBID) model, which will allow Medicare Advantage plans to offer clinically-nuanced benefit packages aimed at improving quality of...more

BakerHostetler

CMS Continues Its Focus on Quality Initiatives with the FY 2016 IPPS Final Rule

BakerHostetler on

On July 31, 2015, the Centers for Medicare and Medicaid Services (CMS) issued a final rule (Final Rule) updating fiscal year (FY) 2016 Medicare payment policies and rates under the Inpatient Prospective Payment System (IPPS)...more

King & Spalding

Also In The News - Health Headlines - August 2015

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CMS Issues SNF Final Payment Rule for FY 2016 – On July 30, 2015, CMS released the final Medicare FY 2016 payment rule for skilled nursing facilities (SNFs). The final rule will result in an estimated increase of $430 million...more

Mintz - ML Strategies

Health Care Update - August 2015

Mintz - ML Strategies on

CMS Releases Final Payment Rules (IPPS, IRF, LTCHs, Hospice, and Psych): At the end of last week, the Centers for Medicare and Medicaid Services (CMS) released a set of final 2016 payment rules affecting acute care hospitals...more

McDermott Will & Emery

Medicaid Managed Care Update: Accelerating State-Led Payment and Delivery System Reform

McDermott Will & Emery on

In the wake of the implementation of the Affordable Care Act, the recent Medicare Managed Care Proposed Rule (the Proposed Rule) exemplifies the accelerated push by the Department of Health and Human Services and Centers for...more

King & Spalding

CMS Proposes Initiative to Tie Home Health Payments to Quality Performance

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On July 10, 2015, CMS published in the Federal Register the CY 2016 Home Health Prospective Payment System proposed rule effective for episodes ending on or after January 1, 2016. CMS estimates that the net impact of the...more

McDermott Will & Emery

CMS Proposes Value-Based Purchasing Model, Other Updates to the 2016 Home Health Prospective Payment System

McDermott Will & Emery on

The U.S. Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) published its proposed update to the home health prospective payment system (HHPPS) for calendar year (CY) 2016 in the July...more

Mintz - Health Care Viewpoints

Delivery System Reform 2.0: Scaling Alternative Payment Models is the New Normal

For some health care providers, a pair of recent announcements made by the Obama Administration to implement mandatory alternative payment models (APMs) for home health value-based purchasing and bundled payments for hip and...more

Manatt, Phelps & Phillips, LLP

An Examination of Fee-Splitting Statutes in the Context of Value-Based Health-Care

One of the goals of the Affordable Care Act is to align incentives among provider communities and their patients and partners. This effort to create communities of common interest with mutually beneficial incentives is now a...more

Sheppard Mullin Richter & Hampton LLP

Shifting to Value-Based Reimbursement

The Blue Cross Blue Shield Association released an interesting survey over the summer (July 2014) that provides further evidence of the change that is now happening in the American healthcare delivery system....more

Faegre Drinker Biddle & Reath LLP

Early Report on Value-Based Purchasing: Less to It Than Meets the Eye?

Medicare’s Value-Based Purchasing (VBP) program produced no improvement in either quality of care or patient satisfaction during its first nine months of operation. That’s the finding of a study led by Andrew Ryan, of the...more

BakerHostetler

CMS Outpatient and Physician Payment Rules: Don't Miss the Efficient Quality of Care Reform Forest for the Dollar Trees

BakerHostetler on

The final physician fee schedule (PFS) and hospital outpatient department payment rules for FY 2014 clearly signal the continued intent by the Centers for Medicare and Medicaid Services (CMS) to transform the healthcare...more

Baker Donelson

CMS Releases CY 2014 Hospital OPPS and ASC Final Rule

Baker Donelson on

CMS has published its Calendar Year (CY) 2014 Final Rule for Medicare policy and payment rates for hospital outpatient prospective payment systems (OPPS) and Ambulatory Surgical Center (ASC) services. This final rule with...more

King & Spalding

CMS Releases FY 2014 Hospital IPPS Final Rule

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On August 2, 2013, CMS released the annual Hospital Inpatient Prospective Payment System Final Rule for FY 2014 (the “Final Rule”), effective for discharges occurring on or after October 1, 2013....more

Troutman Pepper

Homeless Readmissions In Los Angeles – A Community Acts

Troutman Pepper on

After years of planning and in response to the reality of cuts from Medicare due to excessive readmissions, more than 30 Southern California hospitals and health systems and other providers gathered on June 10, 2013 to kick...more

King & Spalding

CMS Provides Progress Report to Senate Finance Committee on Healthcare Reform Efforts, Highlighting Decrease in Hospital...

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On February 28, 2013, the acting principal deputy administrator and director of CMS, Jonathan Blum, provided a progress report to the Senate Finance Committee on CMS’s efforts to reform the healthcare delivery system,...more

Polsinelli

What Hospitals Should Know About Payment Changes For 2013

Polsinelli on

In response to the government’s continued focus on improving quality of care through payment policy, several changes to new and existing regulatory requirements recently came about through the 2013 Inpatient Prospective...more

Katten Muchin Rosenman LLP

The Hospital Medical Staff of the Future Webinar Series, Part III: The Jigsaw Puzzle: Credentialing and Privileging Providers in...

In this presentation: - Overview of New Alignment Initiatives - Board of Directors oversight of new Performance Standards - Review Methods for Credentialing/Privileging Providers using New Metrics ...more

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