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The Centers for Medicare & Medicaid Services (CMS) have released the Notice of Funding Opportunity (NOFO) for the Community Health Access and Rural Transformation (CHART) Model.
The CHART Model is consistent with the President’s Executive Order on Improving Rural Health and Telehealth Access and aims to improve health care quality and reduce Medicare and Medicaid expenditures within rural communities. The CHART Model is voluntary and will include the Community Transformation Track and the Accountable Care Organization (ACO) Transformation Track.
This NOFO is specific to the Community Transformation Track, and CMS will release information on the Accountable Care Organization (ACO) Transformation Track at a later date. The Community Transformation Track consists of three core program elements: funding to establish partnerships and technical support, operational flexibilities, value-based payment
The Community Transformation Track will begin with a Pre-Implementation Period, during which a Lead Organization will develop a strategy to implement health care delivery system redesign. In total, Lead Organizations will have six performance periods to implement their transformation plan. A Letter of Intent (LOI) to Apply is due on January 18, 2021 and applications will be accepted until February 16, 2021.
CMS Issues New Roadmap for States to Accelerate Adoption of Value-Based Care to Improve Quality of Care for Medicaid Beneficiaries
CMS issued guidance to state Medicaid directors designed to advance the adoption of value-based care strategies across their healthcare systems and align provider incentives across payers. The guidance encourages states to consider the adoption of models in the context of their individual circumstances and the lessons learned from implementing previous payment and service delivery models. Examples of payment models include advanced payment methodologies under fee-for-service, bundled payments, and total cost of care models. Each of these models, and others described in today’s letter to state Medicaid Directors, reflect the Administration’s priorities for a value-driven health care system.
Moving toward a more value-driven healthcare system allows states to provide Medicaid beneficiaries with efficient, high quality care, while improving health outcomes. Value-based care may also help ensure that the nation’s healthcare system is better prepared and equipped to handle unexpected challenges, including the ongoing COVID-19 pandemic.
CDC Releases Survey Showing Patients Delayed Medical Care Due to COVID-19-Related Concerns
The Centers for Disease Control & Prevention have released survey results indicating that by June 2020, an estimated 41% of U.S. adults delayed or avoided medical care due to concerns relating to COVID-19. Those who are most at risk for virus complications were the most likely to report avoiding medical care during the pandemic, specifically minority groups, people with at least two underlying conditions, and unpaid caregivers for adults. A third of adults also stated they delayed routine care such as annual checkups.
Researchers worry that delayed or avoided medical care may have long-term implications for the management of chronic conditions, early diagnoses of chronic and acute conditions, and receipt of routine vaccinations. Researchers recommend additional public outreach outlining the risks of delaying needed care; the importance of timely emergency care; and describing the precautions facilities are taking to reduce exposure risk to COVID-19. Researchers note that providing accessible telehealth or in-home health care could address gaps in care.
CMS Releases Part I of Advance Notice of Methodological Changes for CY 2022 for Medicare Advantage Capitation Rates and Part C, D Payment Policies
CMS released Part I of the Advance Notice of Methodological Changes for Calendar Year (CY) 2022 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies. CMS is announcing the MA and Part D payment methodologies three months earlier than usual to provide MA organizations and Part D sponsors more time to take this information into consideration as they prepare their bids for 2022. CMS notes that the accelerated does not impact the calculations and methodologies presented in Part I of the Advanced Notice, but it likely would affect the policies and methodologies of the information included in Part II.
Notably, CMS states it is considering publishing Part II of the Advance Notice in the Fall of 2020 and the Rate Announcement mid-January 2021. However, the Agency may also elect to follow the typical February timeframe for publishing Part II of the CY 2022 Advance Notice and/or the typical April timeframe for publishing the CY 2022 Rate Announcement. They state the final timeline will be determined by the impact that COVID-19 has on rate setting. Comments will be accepted until November 13, 2020.
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