MACRA

AHIP Supports Demo of Medicare Advantage Plans as Advanced APMs

November 14, 2017 - AHIP has voiced its support for a CMS demonstration project that would allow Medicare Advantage (MA) plans to qualify as Advanced Alternative Payment Models (APMs), the organization wrote in a statement to CMS. The payer advocacy group believes that the Quality Payment Program (QPP) has the potential to continue high consumer satisfaction rates...

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AHIP Sees 28% Increase in Medigap Enrollment Among Seniors

by Jesse Migneault

AHIP has released data showing that enrollment in the Medicare Supplement, Medigap, has seen a steady increase from 2014 to December 2015.   The data represents statistics from 11.8 million...

CMS Extends Pediatric Alternative Payment Model Comment Period

by Thomas Beaton

CMS will continue to take public comment on its pediatric alternative payment model (APM) initiatives until April 7, 2017.   In March, CMS issued a request for information (RFI) related to...

Doctors Provide 5 Alternative Payment Model Improvements

by Thomas Beaton

A journal article published in the American Journal of Managed Care, outlines recommendations from several doctors on significant ways alternative payment models (APMs) can be improved and better...

CMS Seeking Feedback on Pediatric Alternative Payment Model

by Thomas Beaton

The Centers for Medicare & Medicaid Services (CMS) recently issued a request for information seeking input on designing an alternative payment model focused on improving care quality and cost (APM)...

CMS Solicits Payer Participation to Next Phase of CPC+

by Thomas Beaton

In support of second round of payer solicitation for Comprehensive Primary Care Plus (CPC+), The Centers for Medicare & Medicaid Services (CMS) has issued a list of frequently asked questions aimed...

Stakeholders Offer Key Principles for Alternative Payment Models

by Vera Gruessner

More than 100 medical organizations sent a letter to President Trump and Vice President Mike Pence on behalf of supporting the healthcare industry’s transition to alternative payment models. The...

84% of Physicians Unsure of Quality Payment Program Conditions

by Vera Gruessner

As many as 84 percent of polled independent physicians and medical staff are unaware of how to meet the requirements of MACRA’s Quality Payment Program, according to a survey from Kareo. The...

20% of Surveyed Physicians Familiar with MACRA Regulations

by Vera Gruessner

No more than 20.6 percent of primary care physicians and 19.5 percent of specialists are “very or somewhat familiar” with MACRA regulations, according to a survey completed in 2016 by...

Medical Organizations Advise Changes for Quality Payment Program

by Vera Gruessner

The healthcare provider community has shown some concern about MACRA implementation and the quality payment program. The Advisory Board released a survey last month showing that 70 percent of 30...

70% of Medical Groups Concerned About MACRA Regulations

by Vera Gruessner

MACRA regulations have impacted the revenue cycle of providers across the country particularly regarding Medicare reimbursement from the Centers for Medicare & Medicaid Services (CMS). The American...

Communication Key for Transition to Alternative Payment Models

by Vera Gruessner

Along with health insurers, more and more providers are expected to transition to alternative payment models (APMs) especially due to MACRA’s Quality Payment Program. For example, urology group...

Top 3 Health Insurance Industry Headlines of December 2016

by Vera Gruessner

Now that the final month of the year is wrapping up and everyone is planning their New Year’s celebrations, a review of the most popular headlines for the health insurance industry may be...

MACRA Pushes Payers to Adopt Value-Based Care Payment Models

by Vera Gruessner

This past summer, the Labor Department announced that healthcare spending rose in August more steeply than at any point in more than 30 years. The costs for medical treatment grew by 1 percent in just...

Why Value-Based Care Reimbursement, MACRA are Here to Stay

by Vera Gruessner

The outcome of the presidential election has led to some uncertainty throughout the healthcare industry when it comes to legislative changes and medical coverage. However, providers and payers will...

CMS Commits to Improved Care Quality, Medical Spending Cuts

by Vera Gruessner

The Centers for Medicare & Medicaid Services (CMS) will continue to work toward creating a better healthcare system for patients while keeping close track of medical spending regardless...

Quality Metrics Pose Problems for Value-Based Care Reimbursement

by Vera Gruessner

The healthcare industry’s fast pace transition to value-based care reimbursement has led to some major challenges for both providers and payers. Adopting completely new payment contracts...

Payers Benefit from Aligning with MIPS, Value-Based Care

by Vera Gruessner

While healthcare regulations like MACRA legislation often centers around impacting medical providers, the health insurance industry is also integrated into the tapestry of value-based care and...

How to Fix Obama’s Affordable Care Act Without a Repeal

by Vera Gruessner

Now that a new President and a Republican-controlled Congress has been elected, what does the future for healthcare reform and the Affordable Care Act (ACA) look like? What will happen to the...

How Payers Could Adjust to MACRA Regulations, Value-Based Care

by Vera Gruessner

MACRA regulations may seem overly complex and lengthy for the average medical practice but there are steps that providers can follow to succeed under MACRA’s quality payment program. Providers...

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