Current & Emerging Payment Models

While the AHA is pleased that CMS will provide hospitals and health systems with an improved update to outpatient payments next year compared to the agency’s proposal in July, the increase is still insufficient given the extraordinary cost pressures hospitals face from labor, supplies, equipment,…
President Biden directed the Center for Medicare and Medicaid Innovation to consider new payment and delivery models to lower drug costs and promote access to innovative drug therapies for beneficiaries.
CMS will extend through 2025 the Bundled Payments for Care Improvement Advanced model, which was set to expire this year.
Since the onset of the COVID 19 pandemic in March 2020, our nation’s hospitals and health systems have coped with intense pressure on staff and resources. Hospitals also are facing a host of other related challenges, including workforce shortages, supply disruptions, and rising expenses. These…
Health care providers who received Provider Relief Fund payments exceeding $10,000 total between Jan. 1 and June 30, 2021, must report to the Health Resources and Services Administration by Sept. 30 on how they used those funds or face enforcement actions such as repayment or exclusion from…
The Centers for Medicare & Medicaid Services has finalized an indefinite delay in the start date of its radiation oncology model, according to a final rule published yesterday.
The Centers for Medicare & Medicaid Services (CMS) August 1 issued its hospital inpatient prospective payment system (PPS) and long-term care hospital (LTCH) PPS final rule for fiscal year (FY) 2023. The rule affects inpatient PPS hospitals, critical access hospitals (CAHs), LTCHs and PPS-…
The Centers for Medicare & Medicaid Services (CMS) July 15 released its calendar year (CY) 2023 outpatient prospective payment system (OPPS) and ambulatory surgical center (ASC) proposed rule that would increase OPPS rates by a net 2.7% in CY 2023 compared to CY 2022.
Stacey Hughes Executive Vice President American Hospital Association July 15, 2022