The Centers for Medicare & Medicaid Services is accepting applications from eligible entities — including hospitals that employ clinicians, critical access hospitals and rural health clinics — to participate in the Primary Care Initiative’s professional and global direct contracting options in calendar year 2020. Both options offer capitated payment and performance-based shared savings and losses. Participants in the professional option will retain half of any savings and pay back half of any losses to Medicare under the model, while participants in the global option will retain all savings and pay back any losses. The 2020 implementation period will provide an opportunity for direct contracting entities, especially those who have not traditionally provided services to a Medicare fee-for-service population, to conduct outreach for voluntary alignment of beneficiaries to the model. CMS plans to open an application period next spring for entities interested in starting in 2021, the first of five performance years for the model. Prospective applicants who have not already submitted a non-binding letter of intent to apply must do so by Dec. 10. For more information, see the CMS factsheet.  

Headline
The Department of Health and Human Services Office of Inspector General June 11 released two reports on high rates of coverage denials by Medicare Advantage…
Headline
The Hospital Insurance Trust Fund has been projected to become insolvent in 2033, according to the Medicare Board of Trustees’ annual report released June 9.…
Headline
The AHA provided comments June 9 to the Centers for Medicare & Medicaid Services on its proposed Comprehensive Care for Joint Replacement Expanded…
Headline
The House Appropriations Committee June 4 released the fiscal year 2027 appropriations bill for the Departments of Labor, Health and Human Services, Education…
Headline
Members of Congress and hospital and health system leaders today gathered for a briefing in Washington, D.C., to discuss how payment delays in Medicare…
Headline
Eli Lilly said June 1 it will deny 340B Drug Pricing Program discounts to providers that do not meet its documentation requirements by next week.In a statement…