- Alternative payment model financial settlements: Preparing for and learning from the process
By Christine Ferro, Maggie Alston, L. Daniel Muldoon, Pamela M. Pelizzari | 17 September 2018
This paper focuses on alternative payment model reimbursement methodologies through the lens of the Centers for Medicare and Medicaid Services Oncology Care Model as an illustrative case study.
- Pathways to Success MSSP proposed rule: Beneficiary assignment
By Colleen Norris, Jason McEwen, Jonah Broulette | 07 September 2018
This paper explores the differences between the two beneficiary assignment methods, prospective or retrospective, and considerations for accountable care organizations as they evaluate their options.
- Pathways to Success: MSSP proposed rule: Financial benchmark
By Jill S. Herbold, Cory Gusland, Charlie Mills | 28 August 2018
This brief discusses “Pathways to Success” and the important implications in store for Medicare accountable care organizations.
- Pathways to Success: MSSP proposed regulation: Summary white paper
By Colleen Norris, Cory Gusland, Charlie Mills, Hugh Larson | 20 August 2018
This paper provides a summary of the Centers for Medicare and Medicaid Services’ sweeping proposed regulations that will significantly change the Medicare Shared Savings Program.
- The exclusion of some nursing facility visits from MSSP assignment has potential unintended consequences
By Kathryn V. Fitch, Cory Gusland | 16 April 2018
This article describes the changes in the historical benchmarks and performance expenditures for a number of Medicare Shared Savings Program accountable care organizations and also explains the possible impact of these changes.
- An Overview of the Bundled Payments for Care Improvement Advanced Model
By Samuel Bennett, Pamela M. Pelizzari | 13 March 2018
This paper outlines the major provisions of the newly announced Bundled Payments for Care Improvement Advanced model.
- Is your provider organization maximizing its performance in value-based care programs?
By Rod Martin, Laurie Lingefelt | 06 March 2018
As the use of value-based reimbursement programs and the associated financial impact increases, it is important for providers to be educated on the mechanics of the program and to understand the analytical, operational, and clinical requirements to ensure success.
- Risk adjustment in CMS episode-based payment models: A resource guide
By Samuel Bennett, Thomas D. Snook | 20 December 2017
This paper provides a high-level guide on risk adjustment within the broader scope of four Centers for Medicare and Medicaid Services episode-based payment models.
- Addressing challenges in the transition to value-based care and alternative payment models: A case study in the Oncology Care Model
By Maggie Alston, Christine Ferro, L. Daniel Muldoon, Pamela M. Pelizzari | 11 December 2017
This paper highlights the key aspects of alternative payment model payment methodologies and uses the Centers for Medicare and Medicaid Services Oncology Care Model as a case study to illustrate these concepts.
- Developing alternative payment models under MACRA
By L. Daniel Muldoon, Pamela M. Pelizzari | 01 December 2017
This paper explores key clinical and financial considerations that need to be addressed in a robust alternative payment model proposal.