Current & Emerging Payment Models

Dec 4, 2018
The AHA, jointly filed a lawsuit against the Department of Health and Human Services for finalizing a policy to phase-in a reduction in payments for hospital outpatient clinic visit services furnished in off-campus provider-based departments that are grandfathered under Section 603 of the…
Jul 27, 2021
The Honorable Chiquita Brooks-LaSure Administrator Centers for Medicare & Medicaid Services Hubert H. Humphrey Building 200 Independence Avenue, S.W., Room 445-G Washington, DC 20201 RE: Patient Protection and Affordable Care Act; Updating Payment Parameters, Section 1332 Waiver Implementing…
Jun 21, 2021
Wednesday, August 11, 2021  1 - 2:30 p.m. Eastern; 12 - 1:30 p.m. Central; 10 - 11:30 a.m. Pacific   Partnerships in an Evolving Health Care Landscape    Bridging the Sectors: Integrating Health and Social…
Jun 11, 2021
The Health Care Payment Learning and Action Network has created an advisory team to help identify and prioritize opportunities to advance health equity through alternative payment models and inform its priorities and initiatives.
Jun 8, 2021
Some employers are moving away from offering traditional coverage with a provider network and instead are using reference-based pricing for some or all of services they cover. Under reference-based pricing, the employer (supported by a third party administrator [TPA] or other vendor) pays a set a…
May 7, 2021
Effective immediately, Medicare will pay $750 to administer monoclonal antibodies to COVID-19 patients in their residence or temporary lodging and increase payment to administer them in most other care settings to $450 from $310 to better align payment with provider costs, the Centers for Medicare…
Apr 9, 2021
The Centers for Medicare & Medicaid Services has selected 61 applicants for the Value in Opioid Use Disorder Treatment Demonstration, a four-year Medicare payment model beginning this month for selected health care providers who agree to participate.
Apr 8, 2021
Fifty-three organizations began participating April 1 in the first performance year of the Global and Professional Direct Contracting Model, the Center for Medicare and Medicaid Innovation announced.
Apr 8, 2021
The Centers for Medicare & Medicaid Services issued a proposed rule to update hospice payment rates for fiscal year 2022. CMS proposes a 2.3% ($530 million) net increase to payments, compared to FY 2021.
Apr 8, 2021
The Centers for Medicare & Medicaid Services issued a proposed rule to update skilled nursing facility payment rates for fiscal year 2022.