CMS Rule Making Process Continues Apace

The Centers for Medicare and Medicaid Services (CMS) has been very busy over the last few weeks. The blockbuster news was the emergence of the final Medicaid managed care rule. This is the first update to Medicaid and CHIP (Children’s Health Insurance Program) managed care programs in a decade. The rule will be implemented over a three-year period starting July 1, 2017. CMS also issued the much-anticipated proposed MACRA rule, which will set new procedures for how physicians caring for Medicare patients are paid. Comments to the proposed rule are due June 27, 2016. The goal of this rule is to move physician payments toward alternative payment methodologies that emphasize value over volume. Two good places to start in thinking about the MACRA rule include Center for Consumer Engagement in Health Innovation Director Dr. Ann Hwang’s blog post on MACRA, which provides a good summary of what MACRA might mean for consumers, and this rule summary.

Other News from CMS

Rulemaking wasn’t the only news out of CMS. Under pressure from hospitals and Congress the agency delayed releasing its new hospital quality rating measure one day before its scheduled launch. The new launch is scheduled for July, though CMS has indicated it may delay releasing the measure even beyond that. CMS has also extended the deadline for applications to its Next Generation Accountable Care Organization (ACO) Model to May 20, 2016. Finally, the CMS Office of Minority Health released a report on racial and ethnic disparities in the Medicare Advantage program. The report provides information on measures related to both patient experience and clinical measures.   

Reports Emerging on Dual Eligible Demonstrations

The Medicare-Medicaid Coordination Office (MMCO) has issued an update on the many ways it is working to streamline Medicare and Medicaid program rules, requirements and policies. The MMCO also released a high-level summary of Consumer Assessment of Healthcare Providers and Systems (CAHPS) results from the dual eligible demonstration projects that began in 2013 and 2014 (California, Colorado, Illinois, Massachusetts, Ohio, Virginia and Washington). In addition, Medicare Payment Advisory Commission (MedPAC) staff provided a broader status report on the demonstration projects at last month’s MedPAC’s quarterly public meeting.