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Capitol Correspondence - 12.03.19

Big Picture: CMS Issues 2 New Medicare Payment Models – Potential Precedent for Medicaid?

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Politico Pulse’s report that the Centers for Medicare and Medicaid Services (CMS) issued new payment models for Medicare caught ANCOR’s interest because of the potential traction these changes might gain in the future for Medicaid, for which the Trump Administration has long sought to curtail funding and in which managed care is increasingly playing a role. Medicaid funds the majority of disability supports in the United States.

As reported by Politico Pulse:

“CMS released Monday key details of two new payment models, both of which were signature initiatives of recently departed CMMI head Adam Boehler.

The two voluntary direct contracting models are (1) aimed at having larger providers and entities shoulder financial risk, and (2) testing whether that saves Medicare money and increases the quality of care. The performance period begins in 2021, with a Dec. 10 deadline to submit a letter of intent to participate, POLITICO’s Rachel Roubein reports.

There will be two application periods, which the National Association of ACOs applauded as giving the provider community more time to “understand important details” and “weigh their participation options.”

Readers interested in learning more about this topic might also be interested in this post by ML Strategies.