Here are five key points from the article:
1. The Centers for Medicare and Medicaid Innovation was developed with the ACA law to support innovative payment models to improve the quality of care while lowering the cost per capital.
2. The Department of Health and Human Services committed to having 50 percent of all Medicare payments tied to quality or value through alternative payment models by 2018. Around 90 percent of all remaining Medicare fee-for-service payments are scheduled to be tied to value or quality by then as well.
3. Last year the House of Representatives passed the Medicare Access and Children’s Health Insurance Reauthorization Act of 2015 to include the sustainable growth rate formula fix. The Centers for Medicare and Medicaid Services Office of the Actuary also noted favorable value-based delivery models for 2019 legislation where payments to physicians that are participating in such models would constitute 60 percent of Medicare physician spending and continued increases.
4. CMS launched the Comprehensive Care for Joint Replacement last year, which is a mandatory program for orthopedic bundled payments in 75 geographic regions.
5. State Medicaid and commercial payers are increasingly engaging in payment reform strategies with value-based constructs.
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