CMS announced the participants for the Comprehensive ESRD Care Model, a new accountable care organization model for Medicare patients with end-stage renal disease (ESRD). The model brings together dialysis facilities, nephrologists and other providers to form ESRD Seamless Care Organizations (ESCOs) to coordinate care for ESRD beneficiaries and reduce costs. The ESCOs will be financially accountable for quality outcomes and Medicare Part A and B spending for ESRD beneficiaries, including all spending for dialysis services.Read More
According to a blog by Patrick Conway, CMS Deputy Administrator for Innovation and Quality and Chief Medical Officer, CMS is showing promising results for the first shared savings performance year of the Comprehensive Primary Care (CPC) model. The initiative was launched in October 2012 to advance primary care by paying clinicians to deliver accessible, comprehensive and coordinated care and is part of CMS's broader effort to promote better care, smarter spending, and healthier people.
In performance year 2014, CPC practices showed positive quality results, with hospital readmissions lower than national benchmarks and high performance on patient experience measures, particularly on provider communication with patients and timely access to care. CPC practices that demonstrated high quality care and reduced spending above a threshold shared in savings generated for Medicare.Read More
According to a story released by Kaiser Health News, the Government Accounting Office (GAO) has found that Medicare’s quality incentive program for hospitals, which provides bonuses and penalties based on performance, has not led to demonstrated improvements in its first three years.
GAO's analysis found no apparent shift in existing trends in hospitals' performance on the quality measures included in the HVBP program during the program's initial years. However, shifts in quality trends could emerge in the future as the HVBP program continues to evolve. For example, new quality measures will be added, and the weight placed on clinical process measures—on which hospitals had little room for improvement—will be substantially reduced.Read More
The Centers for Medicare & Medicaid Services last week announced the Medicare Advantage Valued-Based Insurance Design Model, which will test whether encouraging plan enrollees with certain conditions to consume high-value clinical services through reduced cost sharing and other approaches improves quality and reduces costs.Read More