ICYMI: Notes from the field for October 2019

DATE: 11/05/2019

This month saw many policy updates and changes, as well as new reports on the progress of value-based initiatives. Here’s what we were thinking about this month—what caught your attention?

CMS policy updates and changes

Improving coverage

Improving overall care quality

  • Accelerating the shift to success in value-based care will require a key stakeholder: the chief financial officer. As hospitals and health systems look to take on more risk, there’s a hiring race on to find CFOs who can effectively increase adoption while protecting margins.
  • The U.S. Digital Service was born out of the poorly executed launch of the website to enroll people in the newly passed ACA. Since then, efforts have been focused on modernizing legacy IT systems to support the move to value-based care and meeting CMS requirements. The U.S. Digital Service has been functioning like a start-up within the government and is delivering real results.
  • The Patient-Driven Groupings Model will dramatically change home health reimbursement beginning in January 2020. Similar to the Medicare Prospective Payment System, there will be a consolidation of providers. Effective change management will be a key driver for the organizations that will succeed during the transition to PDGM.
  • CMS announced more than 1,500 participating hospitals will receive about $1.9 billion in bonuses for fiscal 2020 under CMS’ Hospital Value-Based Purchasing Program. The results are about the same as last year, with about 55% of participants scoring bonuses.