July brings us baseball, fireworks, and CMS’s Proposed Rules. In 2,248 pages of proposals, CMS has outlined its plans for MIPS, ACOs, and other Advanced Alternate Payment Models, and how they will transition from fee-for-service into a value-based care arrangement through the Quality Payment Program (QPP). We already know from the 2024 Final Rule that […]
The 2024 CMS PFS Final Rule: Post-PHE, Value-Based Care Returns to the Forefront
The 2024 Physician Fee Schedule Final Rule—all 2,709 pages worth—was released on November 3, and the significance of the “Post-COVID” rule cannot be understated. With the Public Health Emergency expiring earlier this year, these finalized policies are intended to get the proverbial train back on its tracks, following the massive derailment in March 2020. Although […]
The 2024 CMS PFS Proposed Rule: 7 Attempts to Balance Participation Goals with Value
Reading between the many lines in the 1,920-page 2024 Medicare Physician Fee Schedule (PFS) Proposed Rule, one thing is clear: CMS is still struggling to move providers into Advanced Alternate Payment Models (APMs) and keep existing ACOs moving forward on the path to value-based payments. The APP Reporting tug-of-war between CMS and ACOs results in […]
2023 PFS Final Rule: 8 Key Strategies that Boost New ACOs and Increase Health Care Access
It’s here. The 2023 CMS Physician Fee Schedule Final Rule has been released, and in a mere 3,304 pages, CMS has largely finalized its proposals from over the summer. To save you from pouring through all the minutiae, here’s what you need to know. Overall, in this Final Rule, CMS has codified principles to fulfill […]
CMS 2023 Proposed Rule Accelerates ACOs, MVPs
CMS just set off summer fireworks, amping up incentives to adopt Value-Based Care in its just-released, 2,066-page 2023 Proposed Physician Fee Schedule Rule. By encouraging formation of new ACOs, the Proposed Rule establishes a pathway to expand beneficiaries’ access to accountable care. Last year, CMS committed that every Medicare beneficiary will be in an accountable […]
The 2022 CMS PFS and QPP Final Rule: A Warning Shot to Provider Holdouts of Value-Based APMs
CMS has released the 2022 Physician Fee Schedule and Quality Payment Program (QPP) Final Rule, and the message of these 2,414 pages is clear: CMS wants to push providers into value-based care arrangements. That intent was foreshadowed by the Proposed Rule released over the summer, which confirmed our predictions of trends under the Biden administration. […]