Many of the Center for Medicare and Medicaid Innovation’s value-based care payment models are undergoing a review, according to the Centers for Medicare & Medicaid Services.
- Community Health Access: CMS has delayed requests for applications from ACOs to participate in the Community Health Access and Rural Transformation Model. The two-track payment model aims to test if upfront investments or prospective beneficiary per month payments will improve rural healthcare access and quality while reducing costs.
- Intensive Primary Care : CMS is reviewing the Primary Care First payment model’s seriously ill population component. There will be a delay in the payment model component which was slated to start April 1. The component aims to improve care for the seriously ill population covered by Medicare, who lacks a primary care practitioner or care coordination.
- Kidney Care plans: There will be a delay in the first performance year of its Kidney Care Choices payment model. The performance year was slated to start April 1, but it was pushed back to Jan. 1, 2022. The five-year Kidney Care Choices model aims to encourage better care management for Medicare patients with chronic kidney disease and kidney failure by adding financial incentives.
- Contract of Geography Direct Model: Under the proposal, participants would take responsibility for the total cost of care for a portion of Medicare fee-for-service beneficiaries in a specific region. Within each region, direct contracting entities, such as ACOs, with experience in risk-sharing arrangements would partner with healthcare providers and community organizations to better coordinate care. This too is likely to be delayed.
- Payment Modernization Model: CMS will not move forward too with two major proposed changes to the Part D Payment Modernization Model. The two changes, set to take effect in 2022, offered insurers more formulary flexibilities.
