Year: 2018
Mandatory Bundled Payments on the Horizon
Requiring APMs Necessary to Test Efficacy and Spur Reform, Azar Says
There are continuing indications that mandatory alternative payment models (APMS), including mandatory bundled payments, are coming. During remarks to the Physician-Focused Payment Model Technical Advisory Committee (PTAC) on September 6, 2018, Alex Azar, secretary for the Department of Health and Human Services (HHS), stated, “We need strategies and models that provide better care at a lower price…in some cases that’s going to mean mandatory models from CMMI and other mandatory reforms.”
Continuing Signals for APMs, Including Mandatory Bundled Payments
In November 2017, prior to Azar’s confirmation as secretary, the Centers for Medicare & Medicaid Services (CMS) canceled two mandatory bundled payment models that were scheduled to begin January 1, 2018, which some interpreted as a pivot towards voluntary models. During Azar’s confirmation hearings in January, however, Azar clearly stated his belief that mandatory APMs may be necessary in order to test the efficacy of those programs. During his recent comments to PTAC, Azar doubled down on the need for mandatory models, saying, “Requiring participation can be necessary to determine whether a model really works, but it may also be necessary to meet what we see as an urgent need for reform.”
CMS Administrator Seema Verma noted that forthcoming models will be focused on high-cost areas such as end-stage renal disease, cancer care, chronic disease and other serious medical conditions.
Two-Sided Risk Part of Overall Strategy
In addition to discussing the need for mandatory models, Azar also touched on the recent proposal by CMS to overhaul the accountable care organization (ACO) Medicare Shared Savings Program (MSSP). The proposed changes would move providers into a risk-bearing model more quickly, regarding which Azar said, “…the best results we’ve seen have been in ACOs that took on two-sided risk—where providers have real accountability for outcomes…that’s why we have now proposed to simplify the ACO system into two tracks, requiring them to take on risk sooner.”
For providers, the message is clear—CMS is committed to advancing value-based care through alternative payment models, and mandatory models with two-sided risk are part of that strategy. Mandatory bundled payments are on the horizon, and providers should start laying the groundwork now in order to succeed under these programs.
2018 National Patient Navigation Compensation Survey Results
Download Patient Navigation Compensation Survey Results:
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¹“Occupational Employment and Wages, May 2017: 29-1141 Registered Nurses.” U.S. Bureau of Labor Statistics, U.S. Bureau of Labor Statistics, 30 Mar. 2018, www.bls.gov/oes/current/oes291141.htm. ²“Healthcare Occupations.” U.S. Bureau of Labor Statistics, U.S. Bureau of Labor Statistics, 13 Apr. 2018, www.bls.gov/ooh/healthcare/home.htm. Editor’s note: The initial version of survey results incorrectly stated that the survey was conducted from “late 2018 through early 2019;” this has been corrected to “late 2017 through early 2018.”
Dr. Edward E. Partridge to Speak at 2018 Healthcare Bundled Payments Conference
UAB Medicine Partners With Guideway Care for COPD Care Guidance
About Guideway Care
Guideway Care works with care providers to support patient care post-discharge, achieve better outcomes, improve patient satisfaction and to control the costs of providing outstanding care. At the core of its solution is the training and management of specialized disease-specific Care Guides, non-clinical personnel who assist patients and their families by coordinating care, information, and identifying resources across a broad spectrum of services. In addition, Guideway Care provides proprietary technology solutions and proven protocols to ensure a superior total experience for patients, families, and care providers. Guideway is helping practices meet the requirements of Alternative Payment Models (APMs), including the Bundled Payments for Care Improvement (BPCI) Initiative and the Hospital Readmissions Reduction Program (HRRP).About UAB Medicine
UAB Medicine comprises the School of Medicine and the $4.3 billion UAB Health System that includes all of the University of Alabama at Birmingham’s patient-care activities and 2,300 licensed beds in six hospitals, one of which is UAB Hospital — the third-largest public hospital in the United States, winner of the Women’s Choice award, and one of U.S. News and World Report’s Best Hospitals. UAB is the state of Alabama’s largest single employer and an internationally renowned research university and academic health center; its professional schools and specialty patient-care programs are consistently ranked among the nation’s top 50. UAB is the largest academic medical center in Alabama and one of the top four largest academic medical centers in the United States. UAB’s Center for Clinical and Translational Science is advancing innovative discoveries for better health as a two-time recipient of the prestigious Center for Translational Science Award. Find more information at www.uab.edu and www.uabmedicine.org.A New Direction in Cancer Care – American Healthcare Leaders Magazine Interviews Guideway Care COO
“Working at Guideway Care is one of the most exciting things I’ve ever been able to do in my career,” Graham says. “This company has such a great purpose. We are doing something that improves patient care and population health while making health care more affordable for everyone in the system.”
Read the full article at https://americanhealthcareleader.com/2017/new-direction-cancer-care/.