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New Participants Join CMS Alternative Payment Models
The Centers for Medicare & Medicaid Services (CMS) has announced that more than 359,000 clinicians are confirmed to participate in four of the Alternative Payment Models (APMs) in 2017. Clinicians who participate in APMs are paid for the quality of care they give to their patients. APMs are an important part of the administration’s effort to build a system that delivers better care and one in which clinicians work together to have a full understanding of patients’ needs, CMS officials said. APMs also strive to ensure that patients are in the center of care and that Medicare pays for what works while spending taxpayer money more wisely.
“By listening to physicians and engaging them as partners, CMS has been able to develop innovative payment reforms that bring physicians back to the core practice of medicine — caring for the patient,” said acting administrator Andy Slavitt. “By reducing regulatory burden and paying for quality, CMS is offering solutions that improve the quality of services our beneficiaries receive and reduce costs, to help ensure the Medicare program is sustainable for generations to come.”
The Medicare Shared Savings Program (SSP), Next Generation Accountable Care Organization (ACO) Model, Comprehensive End-Stage Renal Disease Care (CEC) Model, and Comprehensive Primary Care Plus (CPC+) Model all apply the concept of paying for quality and effectiveness of care given to patients in different healthcare settings. CMS is announcing the participants in each of these models for the 2017 calendar year.
With the recent announcement, participants in the four APMs are improving care delivery in 50 states, the District of Columbia, and Puerto Rico. In 2017, there are:
- more than 359,000 clinicians participating in APMs;
- more than 12.3 million Medicare and/or Medicaid beneficiaries served;
- 562 ACOs across the SSP, Next Generation Model, and CEC Model;
- 121 ACOs in a risk-bearing track, including in the SSP, Next Generation Model, and CEC Model; and
- 2,893 primary care practices participating in CPC+.
DMEPOS Competitive Bidding Round 2019 Announced
The Centers for Medicare & Medicaid Services (CMS) has announced plans to consolidate all rounds and areas included in the Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program into a single round of competition — Round 2019. After the current Round 1 - 2017, Round 2 - recompete, and national mail order competitions conclude Dec. 31, 2018, Round 2019 contracts will become effective Jan. 1, 2019-Dec. 31, 2021. Round 2019 will include 141 competitive bidding areas and have a total of 11 product categories, officials said. The DMEPOS Competitive Bidding Program, mandated by Congress through the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, changes the amount Medicare pays for certain equipment (eg, walkers and wheelchairs) using market-based prices while maintaining beneficiary access to items, services, and quality of care. The program replaces the outdated, inflated fee-schedule prices Medicare paid for these items with lower, more accurate prices to help Medicare and its beneficiaries save money while ensuring access to quality equipment, supplies, and services. This program also helps limit fraud and abuse in Medicare, officials said.
“The Medicare DMEPOS Competitive Bidding Program, combined with other fraud, waste, and abuse initiatives, is currently saving over $2 billion per year,” said acting CMS administrator Patrick Conway, MD. “During the first three years of competitive bidding in Round 2 areas and the national mail order program for diabetes testing supplies, which began on July 1, 2013, CMS has saved approximately $5.5 billion.” Conway also said that monitoring data used to evaluate the effectiveness of the overall competitive bidding program show that implementation is going smoothly, with few inquiries or complaints, without compromising beneficiary health outcomes. For more information, visit www.cms.gov.
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