Understanding The Latest ACO “Savings”: Curb Your Enthusiasm And Sharpen Your Pencils—Part 1

November 12, 2020Garrett SchmittNo CommentsMACRA, pathways, Pathways to Success

In a recent post, the administrator of the Centers for Medicare and Medicaid Services (CMS) reported that the Medicare Shared Savings Program (MSSP) generated $2.6 billion in gross savings in 2019 and $1.2 billion in net savings after accounting for shared-savings payments to participating accountable care organizations (ACOs). Achieving this level of savings would constitute remarkable…

Preparing Providers for Full MACRA Implementation in 2022

September 28, 2020Garrett SchmittNo CommentsMACRA

With the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), CMS did away with the Sustainable Growth Rate model. Now, they are able to reward high-value, high-quality Medicare clinicians with payment increases, while at the same time reducing payments to those clinicians who aren’t meeting performance standards. CMS intentionally wanted to make sure that…

Most ACOs Worried About Rising Advanced APM Thresholds Next Year

September 22, 2020Garrett SchmittNo CommentsAdvanced APM, AHA, AMA, CHIP, MACRA, MIPS, NAACOS

A new survey confirms a growing concern among accountable care organizations (ACOs) – most ACOs are unlikely to meet rising participation thresholds for MACRA’s Advanced Alternative Payment Models (APMs) in 2021. The survey from the National Association of ACOs (NAACOS) recently found that more than 90 percent of ACOs participating in an Advanced APM, including the Medicare Shared…

“Push-Pull” For Providers In Medicare’s Proposed 2021 Rule For Physician Fees And Quality Reporting

August 5, 2020Garrett SchmittNo CommentsAdvanced APM, APM, APMs, MACRA, MIPS

The newly published 2021 CMS Physician Fee Schedule and Quality Payment Program (QPP) Proposed Rule reflects our harsh reality: Operate under the constraints of the COVID-19 pandemic, while moving toward uniformity and Risk. That tension is palpable in the Proposed Rule’s “push-pull” of CMS trying to continue to advance a Value agenda while stuck in the mud…

CMS Drops Proposed Rule Impacting Quality Payment Program, MSSP ACOs

August 4, 2020Garrett SchmittNo CommentsAdvanced APM, APM, APMs, HIE, MACRA, MIPS, NAACOS

The Centers for Medicare & Medicaid Services (CMS) on Aug. 3 released a rule that proposes changes to the Quality Payment Program (QPP) and Medicare Shared Savings Program (MSSP) for 2021. According to federal officials, because providers must stay focused on the COVID-19 pandemic, the number of significant proposed changes to the programs are limited….

AMGA: Advancing Value-Based Care Hinges on Claims Data Access

February 4, 2020Garrett SchmittNo CommentsAMGA, MACRA

AMGA (American Medical Group Association) recently sent a letter to Congress outlining what it views as 2020’s top priorities for medical groups and health systems. Chief among the group’s recommendations was better claims data access for providers and patients in a value-based care world. Congress and the administration have made it clear that how healthcare is financed…

RECORDED WEBINAR: Leveraging ACO Waivers – An Investment Opportunity for Physician Led ACOs

May 14, 2019Garrett SchmittNo CommentsACO, ACOs, APM, Downside Risk, MACRA, Reinsurance, risk management, Risk Strategies, Surety Bonds, Webinar, webinars

 Download Slides  Has your Medicare Shared Savings Program (MSSP) ACO taken full advantage of the many waivers of federal fraud and abuse laws, such as the Stark Law and the Anti-Kickback Statute? During the webinar we will discuss the different types of waivers, what they are, which ones matter to you, how to use…

Recent Progress In The Value Journey: Growth Of ACOs And Value-Based Payment Models In 2018

August 14, 2018Garrett SchmittNo CommentsACA, ACO, ACO Growth, ACOs, David Muhlestein, Health Reform, MACRA, Mark McLellan, MIPS, payment reform, Value Based Reimbursement, VBHC, VBP

The past year saw multiple developments that could affect payment reform—a new administration was getting up to speed, the Affordable Care Act (ACA) was debated and its implementation modified through legislative and regulatory changes, and questions were raised about the future of alternative payment models. Despite this, implementation of the Medicare Access and CHIP Reauthorization…

Doctors worry CMS proposals will slow the move to value-based pay

July 14, 2018Garrett Schmitt1 CommentAHA, AMGA, CMS, MACRA, MIPS, Physician comp, Physician Compensation

An avalanche of new pay proposals from the CMS seeks to reduce provider burden, so much so that it could undermine efforts to shift Medicare to a value-based system, doctors warned. The agency released a 1,400-page proposed rule July 12 that for the first time combined the annual physician fee schedule and the Medicare Quality…

CMS to Waive MIPS for Providers in At-Risk Medicare Advantage Plans

July 2, 2018Garrett SchmittNo CommentsAPM, APMs, MACRA, MAQI, Medicare Advantage, MIPS

CMS recently announced that it advanced a demonstration that would waive Merit-Based Incentive Payment System (MIPS) requirements for eligible clinicians participating in at-risk Medicare Advantage plans. If approved, the Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) demonstration would apply to eligible clinicians sufficiently involved in Medicare Advantage plans that resemble Advanced Alternative Payment Models (Advanced…

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Recent Posts

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CMS to Waive MIPS for Providers in At-Risk Medicare Advantage Plans
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