Medicare Advantage Leads the Way on Value-Based Payments

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Secretary Burwell’s announcement of a major initiative aimed at driving health care providers in Medicare fee-for-service (FFS) to adopt value-based care models is welcome news for beneficiaries, providers and the overall health care system. The initiative focuses on several areas: incentives to promote value-based payment systems, encouraging integration and coordination of clinical services among all… Read more »

Six Things You May Not Have Known about the Medicare Shared Savings Program

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On December 22, the Centers for Medicare & Medicaid Services (CMS) announced that 89 new organizations will join the Medicare Shared Savings Program (MSSP) in January 2015. These accountable care organizations (ACOs) will bring approximately 23,000 additional physicians and other providers into the ACO program, and will likely be the last group of program entrants… Read more »

Commentary: Time for Congress to Make Payments for Telehealth Happen

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The reason that telehealth usage among seniors in Medicare is almost non-existent is because the rules were written at a time when telehealth was used primarily to provide access to care for rural patients. To access a physician remotely, Medicare beneficiaries have to be in a rural area and in an “originating site” defined as… Read more »

Telehealth: An Important Tool in Achieving the Goals of the ACO Program and Why Restrictions Should Be Lifted in Final ACO Rule

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In the recently released proposed rule related to the accountable care organization (ACO) program1 (or Medicare Shared Savings Program, as it is formally known), the CMS contemplated allowing ACOs to utilize and be reimbursed for an important tool in better coordinating care, engaging patients, delivering services efficiently, and reducing costs: telehealth. Congress adopted the ACO… Read more »

It’s Time to Focus on the Value of Medicare Advantage

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As a Democratic staffer in the Senate during the debate and passage of the Medicare Modernization Act in 2003, I was concerned about private plans getting more involved in Medicare. Why were we going to pay commercial plans to do what Medicare does? Would favorable risk be taken out of the Medicare risk pool? Would… Read more »