The agency is considering making changes to several pay models, COVID-19 pandemic policies and quality measurements. »
The decision could force Next Generation accountable care organizations into the Medicare Shared Savings Program next year unless the agency makes more changes.
Regulators also plan to require inpatient rehabilitation and psychiatric facilities to report COVID-19 vaccine coverage among their healthcare personnel.
Forty healthcare organizations signed a voluntary compact that aims to tie 70% of their payments to capitation and other alternative payment models by 2024.
At Sutter Health's Novato Community Hospital, commercial prices ranged more than five-fold for an upper gastrointestinal biopsy.
CMS' average payment for COVID-19 immunizations will jump from $28 to $40 for single-dose vaccines and $45 to $80 for two-dose vaccines. But reimbursement varies depending on what type of provider carries out the immunization and where it's located.
The Medicare Payment Advisory Commission recommended that policymakers continue some expanded telehealth services for one to two years after the public health emergency ends to allow for studies on telehealth's effects on Medicare access, quality, cost and fraud.
Several commissioners argued that the Medicare Payment Advisory Commission's draft recommendation wouldn't go far enough but said it would be a step in the right direction.
Joint replacement, spinal fusion and gastrointestinal surgeries were on average $4,229 less when providers charged a set price.
Experts recommended that CMS promote equity with advanced payment models that prioritize reducing disparities and tie financial performance to health equity outcomes.
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