CMS Current Quality-Pay Programs Unlikely To Reward Device Innovations
This article was originally published in The Gray Sheet
Executive Summary
Under 2015 legislation, CMS is intensely focused on tying payments to quality of care for patients seeing specialists such as gastroenterologists and cardiologists. But because the primary focus of alternative payment plans is on short-term patient outcomes, things like device durability or other long-term impacts from innovation won't easily be rewarded, a Medicare agency official told device-makers May 5.
You may also be interested in...
Could CMS Changes To Bundled Pay Models Stifle Medtechs' Value-Based Pay Plans?
The US Center for Medicare and Medicaid Services proposed downsizing its CJR joint replacement value-based payment model and outright canceling its cardiac procedure bundled payment model. Will the move discourage companies like Zimmer Biomet, Johnson & Johnson, and Medtronic, which have already invested in programs based on the value-based models?
CMS Administrator Seema Verma: What Industry Can Expect
The Senate confirmed former health-policy consultant Seema Verma as administrator of the US Centers for Medicare and Medicaid Services earlier this month, and she was sworn in March 14. Medtech Insight took a look at some of Verma's policy positions affecting industry, including potential changes to accountable care organizations, appropriate-use criteria, the Centers for Medicare and Medicaid Innovation, lab payments, and telehealth services.
Cardiac Care Bundled Pay Models Preserve New Tech Add-Ons, But Still Make Medtech Nervous
The US Center for Medicare and Medicaid Services finalized three new bundled payment models for cardiac care and one for hip surgeries that will prompt hospitals to adopt them by providing clinicians up to 5% more for Medicare reimbursements. The cardiac and joint care models look similar to last year's "Comprehensive Care for Joint Replacement" plan, in that they still permit inpatient new technology add-on payments and outpatient transitional pass-through payments for device use by excluding those costs from episode payment model calculations.