Important Value-Based Reimbursement Models Put on Hold
Friday, March 26th, 2021

According to a series of updates offered on model webpages, the current administration has decided to suspend several popular CMS Innovation Center (CMMI) value-based reimbursement models to analyze model information.

The Geographic Direct Contracting Model and the Kidney Care Choices Model are two of the several value-based payment models affected.

The administration is updating the models, according to the updates on the corresponding webpages, and will divulge more detail as it develops. For the Primary Care First Model, this ensures the alternative for the Seriously Ill Population will not be available in April, as originally planned.

A separate clarification was recently issued for CMS’ biggest value-based payment model, the Medicare Shared Savings Program, which has pushed back the application deadline for accountable care organizations (ACOs) interested in participating beginning in January of next year. The latest deadline for ACOs to send participating provider lists to CMS is August.

The Biden administration hasn’t said how long CMMI will study the models or if those that haven’t launched yet will do so in 2022, as expected. This does not suggest the models will disappear, however. It’s common for the administration to continue to examine the models closely to ensure provider issues, such as perceived duplication and case management, are resolved.

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This update is provided by CareOptimize. We provide healthcare management consulting services and products, managed care solutions, value-based expertise, Nextgen EHR utilities, MIPS consulting, and more. CareOptimize has helped numerous healthcare organizations succeed for more than a decade. For more information, please call 855.937.8475.