Apr 30, 2019 | Post-Acute Care, Skilled Nursing Facilities (SNF)
CMS proposed SNF payment and policy updates for FY2020, which includes full implementation of the payment modification starting October 1, 2019. Full implementation of the payment modification – known as the Patient Driven Payment Model, or PDPM – was widely expected. This proposal only includes small changes to prior announcements, such as broadening the definition of group therapy. The proposal also would increase overall payments to SNFs by 2.5%, which is in line with estimates. Click to read more.
Apr 29, 2019 | Behavioral, Inpatient Psych
CMS recently released proposed updates to the Inpatient Psychiatric Facilities (IPF) Prospective Payment System (PPS). The proposed rule is stable for IPFs, with an estimated update to prospective payment rates of 1.7%, and the addition of one measure to the IPF Quality Reporting Program. Click to read more.
Apr 26, 2019 | Medicare, Physician Fee Schedule, Physicians
CMS recently announced the Primary Cares Initiative, which is a new set of primary care payment models developed by the CMS Innovation Center (CMMI) to test capitated/value-based rates for primary care services in Medicare FFS. This brief includes an overview of the five new payment models that will be offered through two different paths: Primary Care First (PCF) and Direct Contracting (DC). Click to read more.
Apr 22, 2019 | Exchanges, Payers
2019 Open Enrollment into individual market Exchange plans experienced some decline in the number of consumers selecting plans, although the decline was more modest than expected. Although large insurers continue to dominate enrollment in most markets, fewer counties and states had only a single carrier offering Exchange plans. GAO also reported on continued trends in enrollment concentration across individual, small and large group plans into just a few, large insurers. Click to read more
