Medicare Compliance & Reimbursement

Even though the fate of the ACA is in limbo as legislators weigh other options to replace it, MACRA and the push for value-based care ambles on. However, HHS Secretary Tom Price is a vocal opponent of forced bundling and is not a fan of the efforts by CMS Innovation to promote coordinated care, which remain primary components of the advanced Alternative Payment Models (APMs) under the new Quality Payment Program.

Despite the uncertainty surrounding the future of these programs under a new administration, CMS has put out a Request For Information (RFI) concerning a possible APM focused on pediatrics.

“CMS seeks input through the RFI from the broad community of child and youth-focused stakeholders on concepts critical to addressing the comprehensive health needs of children and youth,” said Patrick Conway, MD, MSc, acting CMS Administrator; Deidre Gifford, MD, MPH, deputy director, Center for Medicaid and CHIP Services; Ellen-Marie Whelan, NP, PhD, chief population health officer, Center for Medicaid and CHIP Services; and Alex Billioux, MD, DPhil, director, division of population health incentives and infrastructure, Center for Medicare & Medicaid Innovation (CMMI) in a joint CMS blog post on Feb. 27, 2017.

The CMS blog post stressed the importance of investing in the healthcare and education of the nation’s youth and mentioned that a third of the children in the United States are covered under Medicaid and CHIP Services. With the RFI, CMS hopes to build on some CMMI ideas to improve state programs, initiate ACOs devoted to pediatric care, and coordinate care for other social services that enhance the health and welfare of children. For more information on the RFI, visit https://innovation.cms.gov/initiatives/pediatric-apm.

Stakeholders are encouraged to make suggestions or expound on innovations they are already implementing to support children’s healthcare.

To read the CMS blog post in its entirety, visit https://blog.cms.gov.