Blog

The Centers for Medicare and Medicaid Services (CMS) only just announced flexibilities to its bundled payment programs due to COVID-19. As of June 18, CMS made an additional announcement for participants and episode conveners in the Bundled Payments for Care Improvement Advanced (BPCI-A) program. Participants should make their clinical episode decisions with care. Ensuring they […]

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On June 9, the U.S. Department of Health and Human Services announced plans to distribute $10 billion in CARES Act Provider Relief Funds to certain safety net hospitals that serve a disproportionate number of Medicaid patients or provide large amounts of uncompensated care. According to the HHS announcement, hospitals qualifying for this funding pool will […]

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As part of the federal fiscal year 2021 Inpatient Prospective Payment System rule change proposed by CMS, two new hip-related diagnostic groups may be added to the Comprehensive Care for Joint Replacement program. CMS has noted that clinically, effective treatment of patients undergoing hip replacement following hip fractures tends to require more resources than those […]

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CMS proposed five new Medicare Prospective Payment System rules for federal fiscal year 2021 that healthcare providers should understand. In addition to the regular updates to the wage index, marketbasket and quality programs, one of the most significant items in these proposed rules is an update to the Core-Based Statistical Areas for all inpatient, skilled […]

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As the COVID-19 pandemic enters its third month in the U.S., the healthcare industry continues to focus on news related to the crisis. Nevertheless, as the wheels of healthcare policy reform roll on, updates to value-based care policy continue to be announced. The continuing COVID-19 crisis How has the $50 billion Provider Relief Fund portion […]

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Following the payments sent to hospitals as part of the Provider Relief Fund, The Department of Health and Human Services began distribution of the $10 billion in COVID-19 relief to rural providers on May 6. Hospitals, rural health clinics and community health centers will each receive a minimum base payment plus a percent of their […]

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Part of the CARES Act, which Congress enacted to help provide financial support to the country during the COVID-19 crisis, included the provision of $50 billion to providers through a special Provider Relief Fund. The funds were issued over 2 installments: $30 billion in the initial distribution and $20 billion in the second — DataGen […]

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As we recently reported, the Comprehensive Care for Joint Replacement program (CJR) is likely to be extended for another three years. As the program ages, the time period used to establish baseline expenditures also changes. As a result, participants should expect target prices to be lower across all census regions for year five of the […]

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Unsurprisingly, COVID-19 was far and away the dominant topic of the month in healthcare. As the pandemic continues, more news and updates from CMS, HHS and Congress have begun to shed light on how healthcare policy will be impacted going forward.  The continuing COVID-19 crisis The next round of funding from CMS to hospitals for coronavirus […]

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CMS released a new proposed rule that would extend the life of its Comprehensive Care for Joint Replacement program. Riding on the success that CJR has demonstrated in helping lower costs for participants, the new rule would keep CJR running for three more years. Under the new proposed rule, CJR would run through December 2023, […]

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