Policy

While you were eating, CMS updated Medicare quality strategy

Right on cue, an HHS agency dropped some news just as everyone was taking off for a long weekend. This time, the CMS waited until just before Thanksgiving to update its strategy for moving away from fee-for-service payments.

Right on cue, a Department of Health and Human Services agency dropped some news just as everyone was taking off for a long weekend. This time, the Centers for Medicare and Medicaid Services waited until just before Thanksgiving to update its strategy for moving away from fee-for-service payments.

The new Medicare quality plan, the first update since June 2014, takes into account progress made in the last year and a half, as well as legislative changes since then, according to CMS CMO and Acting Deputy Administrator Dr. Patrick Conway.

Of particular note is the passage of the “doc fix,” formally known as the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). That law replaced the hated Medicare Sustainable Growth Rate with the complicated Merit-based Incentive Payment System (MIPS).

“The implementation of MACRA is a major opportunity to put a broad range of healthcare providers on the path to value through the new Merit-Based Incentive Payment System (MIPS) and incentive payments for participation in certain alternative payment models,” Conway wrote on the CMS blog.

The update sets six goals meant to point Medicare toward the “Triple Aim” of safer care, improved population health and lower costs.

Conway added:

This document guides the various components of CMS, including Medicaid, Medicare and the Center for Consumer Information and Insurance Oversight, as they work together toward the common goal of health system transformation. We hope that through the communication of the 2016 CMS Quality Strategy Update we continue to build support for and promote the CMS Quality Strategy so that our partners can align initiatives with key CMS desired outcomes

CMS has said it wants 85 percent of all Medicare fee-for-service reimbursements tied to quality or value by the end of 2016, including shifting 30 percent of reimbursements to alternative payment models — think bundled payments or Accountable Care Organizations. The goals rise to 90 percent and 50 percent, respectively, by 2018.

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