CMS Will Test Out Value-Based Model For Primary Care
The Centers for Medicare & Medicaid Services announced that it will test a new primary care model in eight states for a 10-year period. The experiment will weigh the concept of paying Medicare and Medicaid providers for the value of services, rather than the volume.
Axios:
CMS Announces New Decade-Long Primary Care Payment Experiment
The Biden administration on Thursday announced a 10-year experiment aimed at improving the way Medicare and Medicaid pay for primary care. The effort, dubbed the Making Care Primary Model, will ease safety-net and independent primary care providers — including federally qualified health centers — into getting paid for the value of services they provide, rather than the volume. (Goldman, 6/9)
Modern Healthcare:
CMS Debuts Making Care Primary Model To Promote Value-Based Care
In collaboration with state Medicaid agencies, CMS plans to run this pilot program in Colorado, Massachusetts, Minnesota, New Jersey, New York, North Carolina and Washington state through 2034. Applications will be available in late summer 2023, the agency said. (Turner, 6/8)
In other news about Medicare and Medicaid —
Stat:
Top Republican Interested In Site-Neutral Reform For Hospitals
A top Senate Republican signaled his interest in pursuing hospital payment reform to ensure Medicare is paying the same price for services, regardless of where they are provided. The comments are one of the first indications that House Republicans’ interest in reforming hospital payments could have any momentum in the upper chamber. (Cohrs, 6/8)
Forbes:
Big Medicare Changes Coming For Postal Service Retirees
You’ve seen the headlines. The United States Postal Service (USPS) has been losing money. (A recent USPS press release said it’s already lost $2.1 billion this year.) So, Congress passed the Postal Service Reform Act of 2022 (PSRA). ... Starting January 1, 2025, PSHB plans will replace FEHB plans for Postal Service retirees and, to qualify, they must enroll in Medicare Part B. (Omdahl, 6/6)
KFF Health News:
Debt Deal Leaves Health Programs (Mostly) Intact
The bipartisan deal to extend the U.S. government’s borrowing authority includes future cuts to federal health agencies, but they are smaller than many expected and do not touch Medicare and Medicaid. Meanwhile, Merck & Co. becomes the first drugmaker to sue Medicare officials over the federal health insurance program’s new authority to negotiate drug prices. Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico, Lauren Weber of The Washington Post, and Jessie Hellmann of CQ Roll Call join KFF Health News’ chief Washington correspondent, Julie Rovner, to discuss these issues and more. Also this week, Rovner interviews KFF Health News senior correspondent Sarah Jane Tribble, who reported the latest KFF Health News-NPR “Bill of the Month” feature, about the perils of visiting the U.S. with European health insurance. (6/7)
KFF Health News:
Dental Therapists Help Patients In Need Of Care Avoid The Brush-Off
All six of Michelle Ehlert’s children have Medicaid plans that should cover their dental care. But for years, she and her husband paid for dental care out-of-pocket — sometimes thousands of dollars a year. They couldn’t find a dentist near their home in Wilkin County, Minnesota, who accepted Medicaid. When a mobile clinic that would treat Medicaid patients drove nearly 200 miles from Minneapolis to the rural county on Minnesota’s western border, appointments that fit her family’s schedule were “hit-or-miss,” she said. (Saint Louis, 6/9)
