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Last week, the Centers for Medicare and Medicaid Services announced sweeping changes for Model Year 4 of the Bundled Payments for Care Improvement Advanced program. CMS’ own research has revealed that as it currently stands, BCPIA will cause CMS to lose $2 billion over the course of the program. As a result, CMS is making […]

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With each month, we learn more about how COVID-19 is transmitted and the effects of this pernicious disease on those who contract it — as well as the effects of the pandemic on the U.S. economy and the healthcare industry. Taking the pandemic into consideration, CMS continues to adjust its models to support hospitals and […]

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The Centers for Medicare and Medicaid Services is implementing new alternative payment models to address patient care areas that are likely to benefit from more value-based services. In addition to the Kidney Care First model, CMS is rolling out the Primary Care First model, targeted at primary care practices with advanced primary care capabilities. Building […]

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Chronic kidney disease impacts more than 37 million people in the United States and is the ninth leading cause of death. To help treat patients dealing with CKD, in 2019, the Centers for Medicare and Medicaid Services announced its new Kidney Care Choices model, which features two different payment models. One of those models, Kidney […]

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A spike in COVID-19 cases following the loosening of restrictions in some parts of the country is keeping the spotlight on the pandemic, while many in the healthcare industry are alarmed by the dramatic reduction in demand for care for other acute and chronic conditions. Another likely effect of the pandemic is the acceleration of […]

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As DataGen discussed in our recent blog post, “A Change for BPCI Advanced?,” CMS has proposed modifications to its target price methodology to adjust for unforeseen impacts from other policy changes. We noted that we believe a retrospective target adjustment is a good approach, but it should be implemented in ways that increase predictability for […]

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CMS weighing changes to target price methodology BPCI Advanced’s goal is to help practices more effectively deliver high-quality care at lower costs. But, certain policy changes come with unintended confounding factors that make it harder for participants to realize that goal. To ensure the continued viability of BPCI Advanced and other bundled payment programs, CMS […]

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As states begin to open up and our understanding of the coronavirus improves, the end of the pandemic is nowhere in sight. The effects of the crisis on the healthcare industry and ongoing changes in payment and practice policy continue to generate news. The continuing COVID-19 crisis CMS announced preliminary data on COVID-19, through May […]

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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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