Tag Archives: MACRA

IPPS Proposed Rule Increases Hospital Payment; Solicits Ideas for Achieving Transparency, Relieving Administrative Burden

Photo of Amy FoutsPhoto of Ernessa McKiePhoto of Katy ApplebyBy Amy Fouts, Ernessa McKie and Katy Appleby on Posted in Uncategorized
The Centers for Medicare & Medicaid Services (CMS) recently issued its proposed rule updating fiscal year (FY) 2018 payment policies and rates under the Medicare inpatient prospective payment system (IPPS). As highlighted below, the proposed rule aims to reduce regulatory burdens for providers and to promote transparency and flexibility in the delivery of care. Comments … Continue Reading

CMS Finalizes Mandatory Cardiac and Joint Bundles … But Their Future is Uncertain

Photo of Kristen McDermott WoodrumPhoto of Katy ApplebyBy Kristen McDermott Woodrum and Katy Appleby on Posted in Uncategorized
When Tom Price assumes the top post at the U.S. Department of Health and Human Services (HHS) later this month (subject to Senate confirmation), the ink will barely be dry on a final rule issued by the Centers for Medicare & Medicaid Services (CMS) mandating hospital participation in two new cardiac episode-based payment models (EPMs) and an … Continue Reading

Resistance Is Futile: CMS Gets Serious About Antibiotic-Resistant Bacteria

Photo of Kyle GregoryPhoto of Emily CrosbyBy Kyle Gregory, Greg Fosheim and Emily Crosby on Posted in Uncategorized
Antibiotics and similar drugs, known more broadly as antimicrobial agents, are an instrumental weapon in the healthcare armory, rendering once-lethal infections treatable, and dramatically reducing instances of sepsis and secondary infections associated with cancer chemotherapy and organ transplants. However, sub-therapeutic use of antimicrobial agents in livestock, over-prescription, bacterial evolution and myriad other factors have contributed … Continue Reading

Making Sense of MACRA

Photo of Kristen McDermott WoodrumPhoto of Katy ApplebyBy Kristen McDermott Woodrum and Katy Appleby on Posted in Uncategorized
Bracing for the Medicare Part B Overhaul:  Pick a Path, Pick a Pace The countdown has begun for the momentous Part B payment reforms created by the Medicare Access and Chip Reauthorization Act of 2015 (MACRA). On October 14, 2016, CMS released a final rule explaining, in nearly 2,400 pages, how its new Quality Payment Program, established under MACRA, … Continue Reading

Capitol Hill Healthcare Update

Photo of Mike FergusonPhoto of Chris JonesPhoto of Adam HigginsPhoto of Tyler ThompsonBy Mike Ferguson, Chris Jones, Adam Higgins and Tyler Thompson on Posted in Uncategorized
New Bill Targets Drug Prices Bipartisan legislation introduced in the Senate last week would require pharmaceutical manufacturers to alert the U.S. Department of Health and Human Services (HHS) before increasing prices more than 10 percent, continuing congressional pressure on the industry over drug pricing. The bill’s authors – including Sen. John McCain, (R-AZ) – say … Continue Reading

Capitol Hill Healthcare Update

Photo of Mike FergusonPhoto of Chris JonesPhoto of Adam HigginsPhoto of Tyler ThompsonBy Mike Ferguson, Chris Jones, Adam Higgins and Tyler Thompson on Posted in Uncategorized
Upton Acknowledges ‘Cures’ Stalled House Energy and Commerce Committee Chairman Fred Upton (R-MI) acknowledged publicly last week what has been widely suspected on Capitol Hill – his “21st Century Cures” medical innovation legislation will not pass Congress before the November elections. Upton had hoped to push through even a scaled-back version. But lack of consensus … Continue Reading

The Deeper Dive: Senate Finance Committee Examining Modernization of the Stark Law

By Darby C. Allen and Donna S. Clark on Posted in Uncategorized
The Committee’s interest in the Stark Law and receptiveness to feedback from industry leaders may indicate that significant changes to the law are in the pipeline. As the healthcare industry moves from a fee-for-service (FFS) reimbursement system for physicians to a value-based payment system, industry insiders are questioning whether the federal physician self-referral law and … Continue Reading

Year of the Bundle: CMS Proposes New Mandatory Cardiac Bundles and Expansion of CCJR

Photo of Kristen McDermott WoodrumBy Kristen McDermott Woodrum and Greg Fosheim on Posted in Uncategorized
CMS is building momentum with its bundled payment programs and upping the stakes for hospitals. The Centers for Medicare & Medicaid Services (CMS) recently published a proposed rule that furthers the U.S. Department of Health and Human Services’ goal to promote cooperative, value-based care and tie at least 50 percent of Medicare payments to quality … Continue Reading

The Deeper Dive: Medicare’s Fundamental Shift Toward P4P

Photo of Kristen McDermott WoodrumPhoto of Laurice Rutledge LambertBy Kristen McDermott Woodrum and Laurice Rutledge Lambert on Posted in Uncategorized
What priorities should providers focus on in navigating the changing payment environment? 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” earlier this year, the U.S. Department of Health and … Continue Reading

Meaningful Use Stage 3 Final Rule Reduces Provider Burdens

Photo of Lynn SessionsBy Lynn Sessions and Suchismita Pahi on Posted in Uncategorized
CMS and the Office of the National Coordinator for Health Information (ONC) recently released the 752-page final rule for Meaningful Use Stages 2 (MU2) and 3 (MU3). The final rule provides a flexible timeline for providers and reduces the number of objectives and accompanying clinical quality measures required for reporting. The rule further provides that: … Continue Reading
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