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The Healthcare Update eNewsletters are issued on a bi-monthly or monthly basis (depending on the topic). Each eNewsletter is distributed to a highly selective list of individuals specifically interested in readmissions, care coordination, bundled payments, Medicare-Medicaid, patient safety, pay-for-performandce, accountable care, and related issues.

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  • Bundled Payment Update eNewsletter
  • MACRA MIPS/APM Update eNewsletter
  • Pay for Performance Update eNewsletter

From April 9, 2019
Bundled Payment Update eNewsletter #121

CMS to Begin Accepting BPCI Advanced Applications for 2020 in April
The Centers for Medicare & Medicaid Services next month will begin accepting applications to participate in its second cohort of the Bundled Payments for Care Improvement Advanced Model starting in January 2020. Launched last October, the Advanced Alternative Payment model will run through 2023. However, CMS currently does not intend to have enrollment periods for 2021 and 2022. Participants assume risk for patients' health care costs and can qualify for incentive payments and exemption from reporting requirements under Medicare's Quality Payment Program for clinicians if they meet certain quality and other requirements. Acute-care hospitals and physician group practices may apply as a non-convener, meaning they initiate clinical episodes under the model, or as a convener, meaning they bear risk for multiple downstream clinical episode initiators. Post-acute care providers and accountable care organizations may apply to participate as a convener. After the March 1 deadline for participants to withdraw completely or from selected episodes without financial risk, a total of 715 acute-care hospitals and 580 physician group practices are participating this year in the model, which currently includes 29 inpatient and three outpatient bundled clinical episodes. This is down from 832 hospitals and 715 physician group practices in the first year of the model. CMS is finalizing the selection of new clinical episodes for 2020, which will include outpatient total knee arthroplasty. For more information and an updated list of participants, episode initiators and clinical episode selections for 2019 (year 2), visit https://innovation.cms.gov/initiatives/bpci-advanced. (American Hospital Association, March 22, 2019)

From April 17, 2019
MACRA MIPS/APM eNewsletter #38

Panel II: Making the Business Case for Value-Based Care: Real-World Provider Case Studies Show Evidence that Focusing on Value is a Better Business Model than Maximizing Volume

Karen Conway
Vice President, Healthcare Value, Global Healthcare Exchange

David B. Muhlestein
Chief Research Officer, Leavitt Partners, LLC

Sanjay Doddamani
Senior Director in Population Health, Geisinger Health System

David Nace
Chief Medical Officer, MarkLogic

From April 9, 2019
Pay for Performance Update eNewsletter #120

2017 Health Care Cost and Utilization Report
The 2017 Health Care Cost and Utilization Report shows that spending per privately insured person grew by 4.2 percent, the second year in a row of spending growth over four percent. Price increases were the primary driver. The report covers the period 2013 through 2017 and includes claims data from four national insurance companies: Aetna, Humana, Kaiser Permanente, and UnitedHealthcare.

(Health Care Cost Institute, February, 2019)

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