Current & Emerging Payment Models

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
CMS and the Office of the Assistant Secretary for Planning and Evaluation issued their report to Congress.
The Centers for Medicare & Medicaid Services today announced that it will delay indefinitely the payment penalty period of the Appropriate Use Criteria program for advanced imaging services. The program, which was set to potentially go into effect on Jan. 1, 2023, requires imaging provider…
CMS issued its calendar year 2023 proposed rule for the home health prospective payment system, which would reduce net HH payments by $810 million in calendar year 2023 relative to CY 2022.