Multiple Chronic Conditions Blog

I continue to read and review multiple comments made by providers who are pushing back on the upcoming MACRA changes - unfortunately, all of this is bigger and moving faster than any health care tsunami in US history. We have too!

On April 27, the Centers for Medicare and Medicaid Services (CMS) released the long awaited proposed rule establishing the new Quality Payment Program, a framework that includes the Merit-based Incentive Payment System (MIPS) and..

On Tuesday, April 19, 2016 the Older Americans Act (OAA) was reauthorized for three years – an important bipartisan accomplishment. Enacted in July 1965 along with Medicare and Medicaid, the law is a key piece of policy that empowers the Administration for Community Living (ACL) to fund programs across the country that are dedicated to helping seniors stay in their communities.

This month, the US Department of Health and Human Services, National Institutes of Health, National Institutes of Aging, US Census Bureau and the US Department of Commerce, Economics and Statistics Administration released the An Aging World 2015: International Population Reports

March will herald the 6th year since President Obama signed the Affordable Care Act. Yet, significant data suggests that American health care still lacks coordination, is fragmented, expensive, has little accountability and is not focused on the patient. Whether or not providers and organizations have begun to move in the direction of Population Based Health Care, the reality is, there are no options.

In 2015, the Administration and Congress took two major steps to put patients at the center of how health care is reimbursed: The Administration set a goal for 30 percent in 2016 and 50 percent in 2018 - all Medicare payments will be linked to:

The Health Care Payment and Action Network (HCPLAN) announced today the release of the finalized Alternative Payment Model (APM) Framework White Paper. This document provides definition and direction for the country on the new and evolving payment model categories eventually leading into population based payment.

The federal government seeks input from the Measure Applications Partnership (MAP), a public-private partnership convened by the National Quality Forum (NQF), to provide recommendations to the Department of Health and Human Services (HHS) on the selection of performance measures for public reporting and performance based payment programs.

The need for action was enacted by Congress in 2010 with the Affordable Care Act's goal for: Better Health, Better Care and Reduced Cost. By the end of 2018, 90% of Medicare and Medicaid reimbursement will be tied to quality – with at-risk contracts with providers and healthcare organizations – in the form of Accountable Care Organizations, Medical Homes and Bundled Services. In 2020 75% of Commercial plans will be value-based.

By 2018 90% of Medicare fee-for-service reimbursement will be tied to quality. If practices or providers do not participate in the value based reimbursement programs such as meaningful use and provider quality reporting systems (PQRS) in 2016 – expect up to 9% in penalties.