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Robert B. Vogel, MD, JD
Retinal Ophthalmologist at Piedmont Eye Center, Lynchburg VA;
Attorney, Overbey Hawkins & Wright, PLLS, Lynchburg, VA;
Adjunct Professor, Humanities and Bioethics, Liberty University School of Medicine, Lynchburg, VA.
The Centers for Medicare and Medicaid Services (CMS) recently proposed a change to the Medicare Shared Savings Program. The goal is to move accountable care organizations (ACOs) toward a system in which they share in savings they generate but also are responsible for repaying shared losses.
CMS says that its proposal would, among other things, “increase savings for the Trust Funds and mitigate losses, reduce gaming opportunity and increase program integrity, and promote regulatory flexibility and free-market principles.”
According to CMS, most of the 561 ACOs participating in the Shared Savings Program use a one-sided, shared savings-only model. The agency says that under that model, “ACOs receive a share of any savings under their benchmark but are not required to pay back a share of spending over the benchmark.” These ACOs would be asked to sign new contracts reflecting the proposed changes by July 1, 2019.
In a press release, Health and Human Services Secretary Alex Azar said, “One piece of our vision for value-based transformation is pioneering bold new payment models. Having more accountable care organizations take on real risk, while offering them the flexibility they need to generate savings, is an important step forward in how Medicare pays for value.”
Exploring the CMS QAPI Worksheet and Standards
CMS estimated that 86% of adverse events are never reported to the hospital’s PI program, which is why QAPI is an area of focus for surveyors. Our expert will guide attendees through the QAPI worksheet and prepare them for an upcoming survey. This program will cover the CMS QAPI CoPs and proposed changes, QAPI standards on patient safety and risk management, root cause analysis, and the CMS memo on Agency for Healthcare Research and Quality (AHRQ) Common Formats.
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