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Payment Reform

  • Five Top Payer Trends

    January 08, 2018

    The top five payers in 2016 collectively had 125 million members, representing 43 percent of the country’s total insured population.

  • Learn More About How CMS is Preparing SNFs For Value-Based Purchasing Program Rules

    October 30, 2017

    Resources You Don’t Want to Miss

    SNF Value-Based Purchasing

    On November 16, 2017, CMS will focus CMS call will focus on how the Medicare SNF

  • Proposed Updates to the Home Health Care Quality Reporting Program (HH QRP)

    October 10, 2017

    Beginning in 2007, the Home Health Quality Reporting Program (HH QRP) reduces an HHA’s home health market basket percentage by two percentage points if they do not report a set of OASIS, HH CAHPS and other quality measures to CMS on a regular basis. For their own quality improvement work, HHAs

  • The Washington Report: CMS To Reduce Scope of Bundled Payment Models

    August 20, 2017

    The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule in the August 17 Federal Register to reduce the number of mandatory geographic areas participating in the Center for Medicare and Medicaid Innovation’s Comprehensive Care for Joint Replacement (CJR) model from 67 to

  • Mandatory Bundled Payment Cancelled and CJR Model Is Scaling Back: What It Means To Post-Acute Providers

    August 18, 2017

    CMS is cutting the number of locations mandated to participate in the Comprehensive Care for Joint Replacement, or CJR model from 67 to 34. The Episode Payment Models and the Cardiac Rehabilitation incentive payment models which were to begin January 1, 2018 have been cancelled. 

  • 2018 Proposed SNF Rules: The IMPACT Act, Standardized Quality Reporting and Value-Based Purchasing

    May 02, 2017

    CMS has issued its proposed rule to update the Medicare skilled nursing facility (SNF) prospective payment system (PPS) rates and policies for FY 2018. These proposed rules signal market transformation to ready healthcare for the IMPACT Act, standardized patient assessments on quality

  • Are Medicare Advantage Plans The Next Big Play For Post-Acute?

    April 12, 2017

    Medicare Advantage now covers almost a third of all Medicare beneficiaries. In this article, we explore the importance of why Medicare Advantage Plans should coordinate with post-acute providers.

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  • Testing Nursing Home Payments To Reduce Avoidable Hospitalizations

    April 11, 2017

    Seven organizations across the U.S. are testing new payment models and ways to reduce avoidable hospitalizations in nursing facilities. Will the success of these models become the new future for nursing homes? We share the insights with you.


  • The Increase In ACOs Signifies The Market Is Transitioning Away From Fee-For-Service

    April 10, 2017

    The growth in the number of ACOs and alternative payment models (APMs) is advancing rapidly. Learn which models are accelerating the shift from fee-for-service to value-based care.

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  • The Impact Of High Healthcare Spenders In Value-Based Care

    April 03, 2017

    As health system reform shifts payment away from fee-for-service to value-based care models, the incentives to focus on and improve care for high-cost patients will grow.

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