The State of Connecticut Health Plan is the first commercial plan in the country to have its episodes-of-care payment model designated as an Advanced APM by CMS. With limited Advanced APM options via CMS, this designation will provide specialty physicians in the state a path to value-based care payments through the private sector.
In the 1,747-page rule, which will be finalized later this year, CMS proposes expanding access to telehealth for behavioral healthcare, including for the first time allowing Medicare to pay for mental health virtual visits when they are provided by rural health clinics and federally qualified health centers and letting providers offer audio-only telehealth visits for certain services.
Munck Wilson Mandala Partner Greg Howison shared his perspective on some of the legal ramifications around AI, IP, connected devices and the data they generate, in response to emailed questions.
As MIPS and other performance-based payment programs evolve, providers eventually will be on the hook to cut checks if they can't perform. Individual providers must act now to stay on top of the distribution curve.
Physicians planning to avoid participating in MIPS and ignore MACRA may find that the effort required to avoid the penalty is small compared with the energy needed to make up the lost income.