Alternative Payment Models

At the 5th annual Patient-Centered Oncology Care® meeting in Baltimore, Maryland, moderator Bruce Feinberg, DO, was joined by a care provider, a payer, and a community oncology representative to discuss efforts that maintain the patient at the core of payment models.

Be careful what you wish for:  SGR and FFS will be models of the past; the success of the APM and MIPS will rely on compensation, collaboration and participation; and, to date, much remains to be done in the development of quality-based payment reform under MACRA. 

After CMS released its proposed rule for the Medicare Access and CHIP Reauthorization Act, it received overwhelming feedback from clinicians that spurred the agency to make a number of changes for the final rule, according to Kate Goodrich, MD, director of the Quality Measurement and Value-Based Incentives Group in CMS.

CMS has a number of mechanisms in place to help physicians successfully adapt to the Merit-based Incentive Payment System (MIPS) under the Medicare Access and CHIP Reauthorization Act (MACRA), according to Kate Goodrich, MD, director of the Quality Measurement and Value-Based Incentives Group in CMS. These efforts include funding practice transformation and quality improvement networks as well as building partnerships with medical societies.

As the healthcare industry continues its transition towards alternative payment models (APMs), some providers might feel apprehensive about keeping up with new requirements like those in the Medicare Access and CHIP Reauthorization Act (MACRA) final rule. However, these providers can use healthcare information technology (IT), data analysis tools, and other resources to adapt to these changes, according to Suzanne Travis, vice president of regulatory strategy at McKesson.

Read on for a breakdown of what to expect from the near-final MACRA rule announced by CMS on October 14, 2016.

The American Society of Clinical Oncology (ASCO) has announced that it is collaborating with Innovative Oncology Business Solutions, Inc, on ASCO COME HOME.

Read on for a breakdown of what to expect from the near-final MACRA rule announced by CMS on October 14, 2016.

Many oncology practices are still trying to understand the new Oncology Care Model (OCM) structure and focus on data reporting as they simultaneously prepare to adapt to the Merit-based Incentive Payment System (MIPS), said Barry Russo, CEO of The Center for Cancer & Blood Disorders.

What are some of the challenges that clinical practices will face as they implement the Medicare Oncology Care Model (OCM)? What are some of the strategies that have worked for practices using similar payment models? These were some of the questions discussed at the Payer Exchange Summit V.

In the keynote speech at the ACO & Emerging Healthcare Delivery Coalition, Mark McClellan, MD, PhD, director of the Duke-Margolis Center for Health Policy, started out by providing a broad picture of Medicare reform before narrowing it down to what is happening on the ground.

Healthcare attorney James M. Daniel, Jr, JD, MBA, explained how healthcare providers will be impacted by CMS’ newly released final rule on the implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) in a session during the second day of the ACO & Emerging Healthcare Delivery Coalition.

CMS has taken steps to make clinical practice improvement regulations easier for independent practitioners to understand and achieve, said Kate Goodrich, MD, director of the Quality Measurement and Value-Based Incentives Group in CMS.

HHS has issued its final rule on the Medicare Access and CHIP Reauthorization Act (MACRA), which reforms the Medicare payment system as part of the shift to value-based care. Here are 5 things to know about the final rule.

Clinicians may at first be confused by new value-based care regulations, but there are resources to help them understand, said Kate Goodrich, MD, director of the Quality Measurement and Value-Based Incentives Group in CMS.

CMS reached its goals for value-based payments in part because of providers’ enthusiasm for new programs, said Kate Goodrich, MD, director of the Quality Measurement and Value-Based Incentives Group in CMS.

Precision oncology, or the clinically and financially efficient use of genomically matched treatments and clinical trials, is evolving as a potentially important starting point for cancer care within successful alternative payment models.

The Oncology Care Model is one of the most recent bundled payment programs announced by CMS, going into effect July 1. Participants will need a robust data analytics program in order to meet practice requirements, and achieve clinical and financial goals. Read on for tips to achieve data-driven success, and a simulation of what practice data will look like under the model.

An expert panel at The Community Oncology Conference: Innovation in Cancer Care, held in Orlando, Florida, April 13-15, 2016, provided insight on current transitions in healthcare reform, and their predictions for the future.

Measuring the quality of oncology care and associating it with reimbursement, and high drug prices remain important concerns of value-based outpatient cancer care. A healthcare economist reviews the current status and suggests a potential path forward.

Everyone in healthcare is currently grappling with what payment reform will look like in the coming years, and oncology is no exception. Payers, providers, and health policy experts reviewed ongoing changes in the healthcare system and shared their vision on what the future would look like.

The National Coalition for Cancer Survivorship has submitted comments to CMS, providing feedback on the Merit-Based Incentive Payment System and Alternative Payment Models proposed by CMS as it transitions toward value-based reimbursement.

On the second day of the annual meeting of the American Society of Hematology, physicians got together to discuss the real-world needs of alternate payment models in hematology.

The American Society of Clinical Oncology has made public its detailed guidance to CMS, supporting implementation of physician-focused and other alternative payment models under MACRA.

As personalized medicine rapidly becomes an effective tool for combating cancer, payers are exploring new, value-based payment paradigms. These trends will soon intersect, and depending on how they are structured, the new payment models could accelerate or stifle personalized medicine's progress.