PLAYBOOK CHAPTERS:
- OVERVIEW
- INVASIVE PROCEDURE CARE
- PATIENT SAFETY
- WORKFORCE SAFETY
- PATIENT FLOW
- CLINICAL PRIORITIZATION
- FACILITY
- CLINIC / VIRTUAL CARE
- PATIENT SAFETY
- WORKFORCE SAFETY
- PATIENT FLOW
- CLINICAL PRIORITIZATION
- VIRTUAL CARE
- NON-INVASIVE IMAGING CARE
- PATIENT SAFETY
- WORKFORCE SAFETY
- CLINICAL PRIORITIZATION
- FINANCES / REVENUE CYCLE
- REIMBURSEMENT / COST
- WORKFLOW
- METRICS / TOOLS
- STAFFING
- LEADERSHIP & GOVERNANCE
- GOVERNMENTAL FINANCIAL SUPPORT
- QUALITY PROGRAMS
- ORGANIZATIONAL STRUCTURE
- COMMUNICATIONS
- LEGAL / COMPLIANCE
- HUMAN RESOURCES
- EMPLOYEE SAFETY
- LEGAL / COMPLIANCE
- Overview
- Evidence
- Coverage
- CMS NSD
- MA Considerations
- Commercial/Private considerations
- Medicare co-insurance
- New and Pending Legislation
- Traditional Cardiac Rehabilitation
- Program Structure
- Billing/Reimbursement
- PBD Overview Implications
- Intensive Cardiac Rehabilitation
- Extended Evidence
- Program Structure
- Billing/Reimbursement
CMS Innovation Center (CMMI) - NEW!
Alternative Payment Models (APMs) COVID-19 Adjustments
In response to the COVID-19 emergency, CMS is adding certain flexibilities and protections to its stable of APMs. Those covered in the attached PDF are: Click Here
- BPCI – Advanced
- Comp ESRD Care
- Comp CJR
- Direct Contracting
- ET3
- HHVBP
- Independence at Home
- Integrated Care for Kids
- Kidney Care Choices
- Maternal Opioid Misuse Model
- Medicare Care Choices
- MDPP
- ACO Track 1+
- Next Gen ACO
- Oncology Care Model
- Primary Care First
QUALITY PROGRAM UPDATES
PROVIDER RELIEF FUND FAQs
The Health & Human Services (HHS) has issued a “frequently asked questions” guidance document for physicians who don’t file cost reports to complete the portal application. Even physicians who have already received a payment from the Provider Relief Fund can and should still apply if they do not file cost reports. As summarized by the HFMA, the announcement revealed that HHS is using the additional $20 billion it started paying out April 24 to adjust what facilities and providers receive so that the entire $50 billion distribution is based on the facility’s/provider’s portion of net patient service revenue relative to the national total. HHS is using $2.5 trillion as the denominator so the payment calculation for the total $50B “General Distribution” is: (Individual Provider 2018 Revenue/$2.5 Trillion) X $50 Billion = Expected General Distribution.
Download Provider Relief fund FAQs
RISK ADJUSTMENT FAQ
Diagnosis and Documentation:
ACCOUNTABLE CARE ORGANIZATIONS
Flexibilities for QPP - COVID 19 PHE - NEW!
The Centers for Medicare & Medicaid Services (CMS) implemented multiple flexibilities for the Quality Payment Program (QPP) in response to the COVID-19 PHE. Specific flexibilities include:
QPP Response At-a-Glance - NEW!
Understanding the relief efforts associated with QPP and timelines are provided at-a-glance. Click here to find all of the CMS details regarding the APP flexibilities.
