MedPAC Payment Basics
Series of briefs providing an of Medicare payment systems. Covers payments systems including Accountable Care Organizations (ACO), Critical Access Hospitals (CAH), Federally Qualified Health Centers and Rural Health Clinics, hospital acute inpatient services, and more.
Date: 10/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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State Telehealth Laws and Reimbursement Policies Report, Fall 2022
Bi-annual summary report on telehealth policies as of October 2022. Covers Medicaid reimbursement, private payer laws, and professional requirements.
Additional links: Executive Summary, Infographic, State Summary Chart
Date: 10/2022
Type: Document
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Landscape of Area-Level Deprivation Measures and Other Approaches to Account for Social Risk and Social Determinants of Health in Health Care Payments
Examines social determinants of health (SDOH) at the community level and their impact on health-related social needs (HRSNs) of the individual. Discusses how policies related to federal payment systems can incentivize screening for HRSNs as well as referrals to appropriate social and behavioral services. Provides an environmental scan of what measures can be used to provide accountability for funding and policy efforts targeted at SDOH. Includes an appendix that defines and describes indices of social risk, such as the social vulnerability index (SVI) and area deprivation index (ADI), as well as payment models that include measures of social risk.
Author(s): Joshua Breslau, Laurie Martin, Justin Timbie, Nabeel Qureshi, Deborah Zajdman
Date: 09/2022
Type: Document
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, RAND Corporation
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September 2022 MACPAC Meeting Transcript
Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) September 2022 meeting. Covers Medicaid race and ethnicity data collection and reporting, state processes and stakeholder engagement for unwinding continuous coverage requirement, countercyclical disproportionate share hospital policies, and integrating care for dually eligible beneficiaries in Medicaid fee-for-services, among other things. Includes rural references throughout.
Date: 09/2022
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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MedPAC Comment on CMS's Proposed Rule on the Payment Systems for Hospital Outpatient Departments and Ambulatory Surgical Centers for 2023
Comments on a July 26, 2022, Federal Register proposed rule revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023. Includes considerations for payment for 340B drugs, additional facility payments for Rural Emergency Hospitals, telehealth rehabilitation services beyond the COVID-19 public health emergency, and efforts for measuring equity and healthcare quality disparities.
Date: 09/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Assisting American Indian and Alaska Native Consumers
Presentation slides discuss the ACA health insurance marketplace, the Indian Health Services, and provides information for American Indian and Alaska Native people pertaining to healthcare coverage. Presents guidance for AI/AN people to ensure they have consistent healthcare coverage.
Date: 08/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Health Panel Comment Letter – Medicare Advantage Program
Offers comments in response to the Centers for Medicare & Medicaid Services (CMS) Request for Information on various aspects of the Medicare Advantage (MA) program. Presents a rural perspective on the MA program and discusses health equity in the MA program, expanding access to care, and value-based contracting. Includes data on the proportion of MA plans offering supplemental benefits in noncore, micropolitan, and metropolitan counties in 2020.
Date: 08/2022
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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2023 Merit-Based Incentive Payment System (MIPS) Payment Year Payment Adjustment User Guide
Provides information on Merit-Based Incentive Payment System (MIPS) payment adjustments for calendar year 2023. Covers how COVID-19 relief efforts affect 2023 MIPS payment adjustments. Offers answers to frequently asked questions.
Date: 08/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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2020 Quality Payment Program Experience Report
Reports on the clinician experience for those participating in the Quality Payment Program in 2020. Presents data on Merit-based Incentive Payment System (MIPS) eligibility and participation rates for clinicians in small practices and rural areas, as well as their mean payment adjustment scores.
Date: 08/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Synthesis of Evaluation Results across 21 Medicare Models, 2012-2020
Summarizes results from evaluations of 21 Centers for Medicare & Medicaid (CMS) Innovation Center models. Examines measures related to gross and net Medicare spending, utilization, and quality of care. Identifies themes among models with similar participant types and interventions used. Offers considerations for acute or specialty care and targeted populations models and prevention and population management models.
Additional links: Findings at a Glance, Synthesis of Evaluation Results Across 21 Medicare Models Slides, Transcript, Webinar Recording
Date: 07/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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