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A Sampling of Alternative Payment Models.

Richard Self, Janis Coffin

The Journal of Medical Practice Management : MPM

|June 27, 2018

Summary

This summary is machine-generated.

This article explains Centers for Medicare and Medicaid Services (CMS)-approved alternative payment models critical for healthcare providers navigating policy changes. It details how the Medicare Access and CHIP Reauthorization Act of 2015 impacts traditional payments under the Merit-Based Incentive Payment System (MIPS).

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Area of Science:

Healthcare Policy
Health Economics
Reimbursement Models

Background:

The healthcare landscape is shifting from traditional fee-for-service payments.
The Medicare Access and CHIP Reauthorization Act of 2015 introduces significant changes.
Understanding alternative payment models is crucial for provider success.

Purpose of the Study:

To provide a framework of current and proposed CMS-approved alternative payment models.
To assist healthcare providers in navigating evolving reimbursement schemes.
To inform decisions regarding practice environments and financial strategies.

Main Methods:

Review of current Centers for Medicare and Medicaid Services (CMS) approved alternative payment models.
Analysis of proposed models under investigation by CMS.
Framework development for understanding payment model impacts.

Main Results:

Identification of key CMS alternative payment models relevant to providers.
Explanation of how the Merit-Based Incentive Payment System (MIPS) influences traditional payments.
Framework presented for evaluating model suitability.

Conclusions:

Healthcare providers must understand alternative payment models to adapt to policy changes.
The MIPS framework will reshape traditional reimbursement.
Further research is recommended to determine optimal models for specific practices.