Alternative Payment Models
Alternative payment models are becoming more advanced as the government drives to accelerate generated savings. Track and stay ahead of this evolution to identify strategic partnerships and measure results.
Featured Content
Video: Navigate Value-Based Payments
Watch this short video of Fred Bentley from our Provider Practice, discuss insights on navigating the transition from volume to value-based care in a changing healthcare environment.
Podcast: E3 – Positioning for Success in the Merit-Based Incentive Payment System
In the final episode of our QPP podcast series, Nelly Ganesan, one of our MACRA experts, talks about the Merit-Based Incentive Payment System (MIPS) optimization.
Risk-Bearing ACOs Growing in Popularity Under Medicare Programs
On January 18, 2017, the Centers for Medicare & Medicaid Services (CMS) announced the new Accountable Care Organization (ACO) participants in the Medicare Shared Savings Program (MSSP) for 2017.
Podcast: Navigating Bundled Payment Models in 2017
Fred Bentley fills you in on the core components of the EPM final bundled payment rule and the future of bundled payment models.
Avalere Analysis on Final EPM Bundle Rule
Today, the Centers for Medicare & Medicaid Services took another step in shifting Medicare to a value-based payment model that rewards hospitals for delivering better care at a lower cost.
Webinar: EPMs: The Newest Bundled Payment Model
CMS released another mandatory bundled payment proposed rule which will significantly expand the scope of hospitals bearing risk for episodes of care nationally.
Podcast: E4 – The Evolution of Payment Models and the Impact on Life Sciences Companies
In our final bundled payment podcast, Avalere's Adam Borden discusses how the potential updates may impact device manufacturers.
Podcast: E3 – The Episode Payment Model and Its Potential Impacts
In the third podcast in our bundled payment series, Avalere's Mary Ann Clark discusses how the potential updates may impact device manufacturers.
Podcast: E2 – What Mandatory Bundled Payments Mean for Cardiac Care
In episode 2 of our bundled payment podcast series, Avalere's Sally Rodriguez shares how the potential updates may impact post-acute care providers.
New Cardiac Bundles Could Produce Some Big Winners and Losers
Avalere experts say that the impact for most hospitals will be modest.
Podcast: E1 – Potential Expansion in Mandatory Bundled Payment Models
For the month of August, Avalere will cover what the new proposed changes to existing bundled payment programs could mean for the healthcare industry. In an exclusive podcast series, experts will discuss what the new bundles include and where to go from here. Kicking off this series is Fred Bentley from our Center for Payment and Delivery Innovation.
Webinar: Performance-Based Risk-Sharing Arrangements: What Are the Views from the Negotiating Table?
Shifting to a value-based purchasing (VBP) system provides opportunities to engage payer and provider customers in unique contracting and reimbursement relationships that may optimize market access.
Webinar: MACRA: Preparing for a Revolution in Physician Payments
One year after Congress passed the Medicare Access and CHIP Reauthorization Act (MACRA) in a landslide, the Department of Health and Human Services is implementing this legislation to transform physician payment.
Podcast: ACO Prioritization
Listen in as Avalere's Biruk Bekele talks about a new model Avalere has developed to help life sciences companies more effectively target ACOs and customize their value propositions in the diabetes space based on ACO performance. The number of ACOs has grown rapidly in the past few years, reflecting the Department of Health and Human Services’ push to move 50% of Medicare spending to value-based payment models by 2018.
Podcast: Lessons from BPCI and Its Implications for CJR
Our experts share the lessons that we’ve learned from our extensive experience with the Bundled Payments for Care Improvement Initiative. The Bundled Payments for Care Improvement demonstration is a voluntary program sponsored by CMMI in which hospitals, physician group practices, and post-acute care providers accept clinical and financial risk for patients over specified episode time frames post-hospital discharge.
Podcast: Setting Up a Gainsharing Agreement in CJR
In order to better coordinate care across the care continuum, CMS is allowing hospitals to establish “CJR Collaborators” or other providers that share risk with the participating hospital. Listen as Fred Bentley and Erica Breese discuss the details.
The Evolving Role of the Center for Medicare and Medicaid Innovation in Achieving Value-Based Payment Goals
The passage of the Affordable Care Act established the Center for Medicare and Medicaid Innovation (CMMI) to help advance new payment and delivery models.
Podcast: What Is an APM According to CMS?
The Medicare Access and CHIP Reauthorization Act (MACRA) passed last spring is transforming physician payment and standardizing requirements for APMs. Listen as Adam Borden and Jared Alves cover Advanced APMs, incentives CMS offers for providers to participate in APM, and the exclusion of specific tracks.
Webinar: CJR and Beyond: Excelling in an Era of Mandatory Bundled Payment Models
With the launch of the Comprehensive Care for Joint Replacement (CJR) model on April 1, CMS has ushered in a new phase for payment reform. Under this mandatory program, roughly 800 hospitals across the U.S. will assume financial accountability for the cost of all services provided to Medicare patients during 90-day care episodes for hip and knee replacements.
Programs Contributing to HHS Meeting Its Alternative Payment Model Goal Largely Consist of Upside-Only Models
HHS confirms continued movement away from traditional FFS payments, yet significant work remains to move more providers away from upside-risk models and into downside-risk models.