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
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.
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: 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.
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.
Podcast: Avalere’s Take on CJR
Are bundled payments fundamentally changing the way care is provided? Listen in as Fred Bentley, Avalere Center & Payment Delivery Innovation, explains how bundled payment models are spurring clinical innovation and the creation of cross-continuum partnerships.
Sixty Percent of Hospitals Must Reduce Care for Joint Replacement (CJR) Costs Under New Medicare Demo or Face Penalties
Hospitals should focus on care after discharge, which drives more than 39 percent of spending.
Kindred Partners with Avalere and Inovalon to Support Value-Based Payment in Post-Acute Care
Avalere and Inovalon have entered into a multi-year agreement with Kindred Healthcare, Inc., the nation’s largest provider of post-acute care (PAC) services, to deploy the power of data and analytics to engage payers. The combined solutions will result in a data-driven platform that will support Kindred in improving clinical outcomes and promoting coordinated, efficient care under new value-based payment models.
Participation in Risk-Bearing Accountable Care Organizations Triples; CMS Proposes Rule on Medicare Shared Savings Program Benchmark Methodology
The Centers for Medicare & Medicaid Services (CMS) announced that 121 new Medicare Accountable Care Organizations (ACOs) have joined the Medicare Shared Savings Program (MSSP) and Next Generation (Next Gen) ACO models. In addition, 147 MSSP ACOs renewed their contracts. The increase in risk-bearing ACOs and the recently released proposed benchmark rule mark CMS' commitment to shifting from volume to value.
Seasoned Payment and Delivery Expert Joins Avalere
Fred Bentley, an experienced leader in payment and delivery system reform, has joined Avalere’s Center for Payment & Delivery Innovation. Fred will supplement our existing deep expertise in provider strategy and provide analytic and strategic support on issues related to care delivery.