(Mar. 22, 2024) – CMS Announces ACO Primary Care Flex Model
The Centers for Medicare & Medicaid Services Innovation Center announced a new payment model for primary care, the Accountable Care Organizations Primary Care Flex Model. The model would be part of the Medicare Shared Savings Program and will test whether "improved payment for primary care will empower participating ACOs and their primary care providers to utilize more innovative, team-based, person-centered and proactive approaches to care and positively impact health outcomes, quality and cost of care." The ACO PC Flex Model application period opens May 2024, and the performance period begins Jan. 1, 2025.
KCMHC and Real World Learning to Host Career Fair April 4
The Kansas City Metropolitan Healthcare Council, is partnering with Real World Learning, to connect high school juniors and graduating seniors with opportunities in health care. Join these organizations for a career fair from 2:00 p.m. to 6:00 p.m. Thursday, April 4, at the Kauffman Foundation Conference Center, in Kansas City, MO. The fair is free to attend, thanks to our sponsors.
To learn more about the career fair, please contact Molly Weaver.
Change Healthcare Cyberattack Updates Available – AHA Survey Results and Medicaid Advanced Payments
The American Hospital Association released results from a survey to gauge the effect of the recent Change Healthcare cybersecurity breach. According to AHA, 74 percent of hospitals report direct patient care impact, nearly 40 percent report delays in processing health plan utilization requirements, 94 percent report financial impact and 82 percent report impact on cash flow.
The Centers for Medicare & Medicaid S issued guidance outlining processes for an expedited state plan amendment for states to advance fee-for-service payments for providers affected by the Change Healthcare attack. The guidance also highlights the existing authority state agencies have to limit managed care plans' restrictive prior authorization and network practices.
MedPAC Releases March 2024 Report to Congress
The Medicare Payment Advisory Commission released a report to Congress that includes recommendations for fiscal year and calendar year 2024 Medicare payment rates. MedPAC commented that "given the worsened financial circumstances in 2022, and the approximately $3 billion decline in existing Medicare disproportionate share hospital and uncompensated care payments from 2019 to 2024, the Commission contends that all hospitals – and in particular those serving large shares of low-income Medicare patients – warrant greater support than the Commission recommended last year. Thus, the Commission recommends that the Congress update the 2024 Medicare base rates for general ACHs by the amount reflected in current law plus 1.5 percent."
MACPAC Recommends More Transparency and Oversight of Medicaid Managed Care Denials
The Medicaid and Children's Health Insurance Program Payment and Access Commission released the 2024 report to Congress. In addition to the required analysis on DSH, the MACPAC report includes an analysis of Medicaid managed care denial and appeal processes and recommendations for improving transparency and state oversight.
MLN Connects Provider eNews Available
The Centers for Medicare & Medicaid Services issued the following updates to MLN Connects Provider eNews:
Before You Go...
- Because of the disruptions from the Change Healthcare cybersecurity attack, the Centers for Medicare & Medicaid Services released a set of frequently asked questions for hospitals interested in obtaining a Medicare Accelerated and Advance Payment.