Tag: Report

GAO Releases Report on Managing High Cost Medicaid Beneficiaries

The Government Accountability Office (GAO) released a report on identifying, predicting, and managing high-cost beneficiaries in Medicaid. The GAO interviewed seven states that were able to successfully predict beneficiary healthcare expenditures. So...

Final Evaluation Report: GNE Demonstration

The Centers for Medicare and Medicaid Innovation (Innovation Center) posted the final report evaluating the Graduate Nurse Education (GNE) Demonstration. An overview of the major findings can be found here. This demonstration provided payments to fi...

GAO Releases Report on Medicare Spending on Codes for Comprehensive Care Planning Services

The U.S. Government Accountability Office (GAO) recently released a report on Medicare physician spending on longitudinal comprehensive care planning (LCCP) services. This report, which was required by a provision of the Bipartisan Budget Act of 2018...

Second Annual CJR Evaluation Report Finds Continuing Declines in Average Episode Payments

The Center for Medicare and Medicaid Innovation recently released the Second Annual Evaluation Report for the Comprehensive Care for Joint Replacement (CJR) model.  After two performance years, average episode payments decreased by 3.7 percent or $1...

MedPAC Releases June 2019 Report to Congress: Considers a Number of Payment Innovations for Clinician Payment, Medicare Advantage and Part B Drugs

On June 14, 2019, the Medicare Payment Advisory Commission (MedPAC) released its June 2019 Report to the Congress: Medicare and the Health Care Delivery System. Each June, as part of its mandate from the Congress, MedPAC reports on issues affecting t...

PTAC Calls on CMS for More Comprehensive Approach to Wound Care Delivery

The Physician-Focused Payment Model Technical Advisory Committee (PTAC) submitted a combined report to the Secretary of the Department of Health and Human Services (HHS) containing comments and recommendations on two proposals related to wound care d...

CMS Releases 2019 Measure Development Plan Annual Report

On May 31, 2019, the Centers for Medicare and Medicaid Services (CMS) posted the 2019 Quality Measure Development Plan (MDP) Annual Report, which describes progress in developing clinician quality measures to support the Quality Payment Program (QPP)...

Recent Updates from the Innovation Center

The Centers for Medicare and Medicaid Innovation recently posted several documents to their website. Financial Alignment Initiative for Medicare-Medicaid Enrollees The Financial Alignment Initiative is designed to provide individuals dually ...

OIG Report Finds Challenges with ACO Care Coordination

The Office of Inspector General (OIG) held site visits and interviews at six accountable care organizations (ACOs) – four participating in the Next Generation ACO model and two in the Medicare Shared Savings Program – to evaluate how ACOs are usi...

ONC Releases Data Brief on Use of Electronic Records by Office-Based Physicians

As required by the Medicare Access and CHIP Reauthorization Act of 2015 the Office of the National Coordinator (ONC) recently released a report on the use of electronic records by office-based physicians. Overall the report found that interoperabili...

GAO Recommends CMS Improve Transparency Policy for Section 1115 Waivers

On May 17, the Government Accountability Office (GAO) publicly released its report Medicaid Demonstrations: Approvals of Major Changes Need Increased Transparency. Medicaid demonstrations, established through the Section 1115 waiver...

CMS Releases Medicare Advantage Quality Data

The Centers for Medicare and Medicaid Services released a report regarding disparities in quality of care received by Medicare Advantage (MA) beneficiaries.  The report discusses the distribution of race, ethnicity and gender among MA beneficiaries....

CMS Innovation Center Report to Congress

The Centers for Medicare and Medicaid Services Innovation Center released its 2018 Report to Congress.  The report provides an overview of 36 models and initiatives that run between October 1, 2016 and September 30, 2018.  The report includes links...

GAO Finds Significant Medicare & Medicaid Overpayments in Laboratory and Other Services

The Government Accountability Office (GAO) recently unveiled a report criticizing the Center for Medicare and Medicaid (CMS)’s oversight of its medical documentation requirements. Finding over $23 billion dollars in inappropriate Medicare Fee-for-S...

Medicare Spending Projected to Grow to 5.9 Percent of GDP by 2038

On April 22, 2019, the Medicare Board of Trustees released their annual report on the state of the Medicare Trust Fund. The Trustees project that Medicare costs will grow from approximately 3.7 percent of GDP in 2018 to 5.9 percent of GDP by 2038, a...

Innovation Center Posts Fifth Annual Report of State Initiative Models

The Centers for Medicare and Medicaid Services Innovation Center (Innovation Center) posted the fifth annual report of their State Initiative Models. The Innovation Center invested over $250 million in Round 1 Model Test awards to support six states ...

CMS Releases 2017 Quality Payment Program Experience Report

The Centers for Medicare & Medicaid Services (CMS) released its 2017 Quality Payment Program (QPP) Experience Report with Appendix, which provides a comprehensive overview of the clinician reporting experience during the first year of the Quality...

MedPAC to Discuss MACRA-Mandated Report on Clinician Payment in Medicare

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) requires the Medicare Payment Advisory Commission (MedPAC) to conduct a mandated report on clinician payment examining the relationship between Medicare’s payments to clinicians and t...

GAO Report Considers Advantages of Voluntary vs Mandatory Payment Models

On Tuesday, January 22, 2019, the Government Accountability Office (GAO) released Voluntary and Mandatory Episode-Based Payment Models and Their Participants. Using an analysis of Centers for Medicare and Medicaid Services (CMS) data, evaluation repo...

GAO Releases Report on Challenges to Electronically Matching Patients' Records Across Providers

The Government Accountability Office (GAO) released a report required by the 21st Century Cures Act detailing the challenges to electronically matching patients’ records across providers. Health care providers are increasingly sharing pa...

ONC Releases Report to Congress: Adoption Increasing but Recommend Areas for Improvement

As required by law, the Office of the National Coordinator (ONC) released its 2018 Report to Congress. This annual report provides an update on the progress towards the nationwide adoption of electronic use and exchange of health information. The rep...

Administration Releases Report on Healthcare Competition

The Department of Health and Human Services, Department of the Treasury and the Department of Labor released a report on “Reforming America’s Healthcare System Through Choice and Competition.”  The report identifies four areas where f...

MIPS Resource: CMS Posts Details on Beneficiary Assignment Methodology for Groups and Virtual Groups

The Centers for Medicare and Medicaid Services (CMS) recently posted, Merit-based Incentive Payment System (MIPS) 2018 Assignment Methodology Specifications for the CMS Web Interface and CAHPS for MIPS Survey. This report describes the proce...

GAO Report Considers Small and Rural Practices' Experiences in MIPS

The Government Accountability Office (GAO) was asked to review certain aspects of small and rural practices participation in legacy incentive programs and the Merit-based Incentive Payment System (MIPS). The GAO interviewed 23 stakeholders and CMS of...

2018 Measure Development Plan Annual Report Released

On May 3, 2018, the Centers for Medicare and Medicaid Services (CMS) released the 2018 Measure Development Plan (MDP) Annual Report which describes progress in developing clinician quality measures to support the Quality Payment Program (QPP). This a...