MHA Today | April 11, 2019

April 11, 2019
MHA Today: News for Healthcare Leaders

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April 11, 2019

MHA Today is provided as a service to members of the Missouri Hospital Association. Additional information is available online at MHAnet.


In This Issue
UHC Expands Bundled Payments For MA Providers
CMS Releases ACO Case Studies And Care Coordination Toolkit
HHS Launches A Volunteer HIPAA Pilot Program
MHA Reports Medicare Pay-For-Performance Overview

Advocate
state and federal health policy developments


UHC Expands Bundled Payments For MA Providers

Staff Contact: Andrew Wheeler

UnitedHealthcare is building upon existing work with the Centers for Medicare & Medicaid Services’ Bundled Payments for Care Improvement Advanced program for fee-for-service Medicare beneficiaries and expanding the company’s bundled payment offerings for providers participating in its Medicare Advantage plan networks. UHC will offer bundled payment models to providers located in more than 30 states. The bundles will include hip and knee replacements, spinal fusions, and coronary bypasses. UHC is expecting to have $75 billion in provider reimbursement tied to value-based arrangements by the end of 2020.

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Regulatory News
the latest actions of agencies monitoring health care


CMS Releases ACO Case Studies And Care Coordination Toolkit

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services released an ACO Care Coordination Toolkit that shows the work of several accountable care organization models. The intended use of the toolkit is to educate the public about strategies used by ACOs to provide value-based care. CMS also released case studies to help current and future Medicare ACOs find new ways “to make care better, people healthier and spending smarter.”

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HHS Launches A Volunteer HIPAA Pilot Program

Staff Contact: Andrew Wheeler

The U. S. Department of Health and Human Services is launching a volunteer Provider Pilot Program to test the process for reviewing compliance with HIPAA Administrative Simplification rules. Any provider who used electronic health care transactions can volunteer for the program on behalf of themselves. Participants in the pilot program will work one-on-one with HHS to “identify and resolve compliance issues.” Once completed, participants will be exempt from compliance reviews for one year. HHS asks those interested in volunteering to send an email to AdministrativeSimplification@cms.hhs.gov by Wednesday, April 24.

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MHA Reports Medicare Pay-For-Performance Overview

Staff Contact: Andrew Wheeler

As the Centers for Medicare & Medicaid Services continue to tie payments to quality, the mandatory pay-for-performance programs continue to evolve. MHA released an analysis about the hospital readmissions reduction, hospital-acquired conditions and value-based purchasing programs. The analysis includes details about the weighting, hospital performance and financial impact for program years 2017, 2018 and 2019. MHA has free, on-demand webinars about the Medicare pay-for-performance programs.

Policy and analytic studies are available for download to authorized users of HIDI Analytic Advantage®. If you need a user ID and password or have questions about accessing these reports, please contact HIDI.

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Consider This ...

In 2018, male primary care physicians earned about 18 percent more than their female colleagues, and by 2019, it reached 25 percent. For specialists, the pay gap was 36 percent in 2018 and 33 percent in 2019.

Source: Time