{"id":5554,"date":"2018-08-10T17:55:48","date_gmt":"2018-08-10T17:55:48","guid":{"rendered":"http:\/\/tele.healthcare\/?p=5554"},"modified":"2018-08-10T17:55:48","modified_gmt":"2018-08-10T17:55:48","slug":"cms-overhaul-of-aco-rules-includes-a-nod-to-telehealths-value","status":"publish","type":"post","link":"https:\/\/drmiltie.com\/at-home-testing\/cms-overhaul-of-aco-rules-includes-a-nod-to-telehealths-value\/","title":{"rendered":"CMS Overhaul of ACO Rules Includes a Nod to Telehealth\u2019s Value"},"content":{"rendered":"
\n

In its proposal to overhaul the Medicare Shared Savings Program, CMS is planning to reimburse for more telehealth and telemedicine services as it looks to revamp the Accountable Care Organization model.<\/h2>\n<\/header>\n
\n

By Eric Wicklund<\/a><\/p>\n<\/div>\n

In a proposed rule<\/a> published late Thursday, the Centers for Medicare & Medicaid Services (CMS) announced that it wants to begin reimbursing Next Generation ACOs this year for some store-and-forward (asynchronous) teledermatology and teleopthalmology services under the Telehealth Expansion Benefit Enhancement waiver.<\/p>\n

In addition, CMS is proposing expanding coverage in 2020 for some telehealth and telemedicine programs in its Medicare Shared Savings Program that are delivered in areas that aren\u2019t designated as rural or shortage zones. Medicare reimbursements have long been limited to programs in rural regions are parts of the country with a demonstrated shortage of healthcare providers.<\/p>\n

In an article in Health Affairs<\/em><\/a>, CMS Administrator Seema Verma said the overhaul, which renames the MSSP as the \u201cPathways to Success\u201d program, aims to save Medicare $2.2 billion over the next decade.<\/p>\n

\u201cCMS believes that ACOs are promising \u2013 ACOs can, should, and must provide value for patients and taxpayers,\u201d Verma wrote.\u00a0\u201cWe are proposing significant changes to increase quality for patients and drive towards program-wide savings.\u201d<\/p>\n

\u201cIn Pathways to Success, CMS proposes several major changes which leverage new CMS authorities under the Bipartisan Budget Act of 2018,\u201d Verma said. \u201cThese changes include allowing physicians and other practitioners that are taking performance risk to receive payment for expanded telehealth services.\u00a0Physicians could receive payment for certain telehealth services regardless of the patient\u2019s geographical location, including for services furnished to beneficiaries at their home, in order to expand access to high-quality services at a low cost.\u201d<\/p>\n

The connected care changes are relative morsels in a 600-page proposed rule whose primary goal, CMS officials said, is to accelerate the move of Medicare ACOs<\/a> to downside financial risk arrangements that hold the organizations accountable for financial losses and promote competition.<\/p>\n

\u201cPresident Trump has promised the American people better healthcare at a lower cost, and delivering this kind of value is a key priority for HHS,\u201d Health and Human Services Secretary Alex Azar said in a CMS press release<\/a>. \u00a0\u201cOne piece of our vision for value-based transformation is pioneering bold new payment models. Having more Accountable Care Organizations take on real risk, while offering them the flexibility they need to generate savings, is an important step forward in how Medicare pays for value.\u201d<\/p>\n

The proposal has so far drawn mixed reviews. While the National Association of ACOs predicted the overhaul would all but destroy the ACO model, the Health Care Transformation Task Force called it \u201can important step to promote value-based transformation and to push industry momentum forward.\u201d<\/p>\n

In a statement, American Hospital Association Executive Vice President Tom Nickels said Pathways to Success would \u201ccreate barriers to entry in transitioning to value-based care.\u201d<\/p>\n

\u201cWhile we acknowledge CMS’s interest in encouraging providers to more quickly move toward accepting risk, drastically shortening the length of time in which ACOs can participate in an upside-only model ignores the reality that providers are starting at vastly different points and will have vastly different learning curves when moving toward value-based care,\u201d he said.<\/p>\n

Comments on the Pathways to Success program will be accepted through mid-October.<\/p>\n","protected":false},"excerpt":{"rendered":"

In its proposal to overhaul the Medicare Shared Savings Program, CMS is planning to reimburse […]<\/p>\n","protected":false},"author":3,"featured_media":5555,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_uag_custom_page_level_css":"","_uf_show_specific_survey":0,"_uf_disable_surveys":false,"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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