Join us for the CMS National Training Program

Join us for the CMS National Training Program

Monthly Partner Update Webinar

February 2, 2016

2:30 – 3:30 pm ET

 

This webinar will feature presentations on:

·         Form 1095-B – A review of what certain people with Medicare should expect

·         Initial Enrollment Questionnaire – Removal from the Initial Enrollment Package

• Medicare Advantage Plan Disenrollment – A reminder of the disenrollment period

 

Audio Conference Details

Toll-free dial in number: 1-800-603-1774

Conference ID: 95159201

 

Webinar: https://webinar.cms.hhs.gov/NTPUpdateWebinar020216

 

Please join both the audio and webinar portions of this event.

CMS has made the Health Coverage Tax Tool available

With the 2015 tax season underway, CMS has made the Health Coverage Tax Tool available to help consumers with their tax questions. The tax tool helps consumers claim the affordability exemption and calculate their premium tax credit (PTC).

 

Consumers should access the tax tool only if one of the following situations applies:

 

• The information on the consumer’s health care tax Form 1095-A about his or her “second lowest cost Silver plan” is missing or incorrect in Part III, Column B of the form.
• The consumer wants to claim an “affordability exemption,” meaning 2015 coverage was unaffordable to the consumer. If he or she qualifies for this exemption, the consumer does not have to pay the fee for not being covered in 2015.

 

Additional information on these situations is available at: https://www.healthcare.gov/tax-forms-and-tools/. Watch for additional emails from CMS in the coming weeks providing information on additional tools and information on tax season readiness.

 

Remember: While you may provide information to consumers about this new tool, the tax credit reconciliation process, and the tax forms they will receive, it is important that you not provide any tax filing advice or answer any tax filing questions. Please refer those seeking answers to their questions or advice regarding their personal situation to a tax professional for assistance or to the tax assistance options available at IRS.gov/freefile or IRS.gov/VITA.

CMS Releases First Ever Home Health Patient Experience of Care Star Ratings

CMS NEWS

 

FOR IMMEDIATE RELEASE

January 28, 2016

 

Contact: CMS Media Relations

(202) 690-6145 | CMS Media Inquiries

 

 

CMS Releases First Ever Home Health Patient Experience of Care Star Ratings Comparison Ratings that Help Patients Compare and Choose Among Home Health Agencies

 

Today, the Centers for Medicare & Medicaid Services (CMS) introduced the first patient experience of care star ratings on Home Health Compare (https://www.medicare.gov/homehealthcompare/search.html). Known as Home Health Care Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) Survey star ratings, these measures evaluate patients’ experiences with home health agencies.

 

Home Health Compare is the agency’s public information website that provides information on how well Medicare-certified agencies provide care to their patients. The HHCAHPS Survey star ratings report patients’ experiences of care ranging from one star to five stars using data from patients (or the family or friends of patients) that have been treated by the agency. Five stars is the highest rating and reflects the best patient experience. There are over 11,000 agencies with data on Home Health Compare, and more than 6,000 of them now have patient care experience star ratings.

 

Previously, patients could select multiple agencies at a time on Home Health Compare to compare agency performance on individual HHCAHPS items, such as how often the home health team delivered care in a professional way. In addition, patients have also had access to summary Quality of Patient Care star ratings for each agency. These star ratings summarize home health agencies’ performance on nine quality measures that indicate how well they assist their patients in regaining or maintaining important functional abilities and how frequently they adhere to evidence-based processes of care.

 

Now, patients and their family members can go one step further: they can compare information on patients’ experiences of home health care at these agencies through the HHCAHPS Survey star ratings. Starting today, an individual is able to view the following five HHCAHPS Survey star ratings for each home health agency listed on the website:

1. Care of Patients
2. Communication Between Providers and Patients
3. Specific Care Issues
4. Overall Rating of Care Provided by the Home Health Agency
5. Survey Summary star rating

 

Some home health agencies do not have enough data right now to calculate and display star ratings. However, CMS continually updates Home Health Compare, and all of its Compare websites, so those home health agencies that do not currently have patient experience star ratings may have star ratings in the future.

 

“Having the HHCAHPS Survey star ratings on Home Health Compare helps patients and their families make more informed health care decisions and encourages home health agencies to strive for higher levels of quality and patient experience,” said CMS Deputy Administrator and Chief Medical Officer Patrick Conway, M.D., MSc. “We hope patients and their families find this information helpful and visit our other provider comparison websites.”

 

Today’s announcement on Home Health Compare is the latest example of how CMS is committed to transparency and helping patients and their family members make informed health care decisions through an initiative to simplify the quality of care information across all CMS Compare websites. It also supports the larger effort across the Department of Health and Human Services (HHS) to build a health care system that delivers better care, spends health care dollars more wisely, and results in healthier people.

• Nursing Home Compare (https://www.medicare.gov/nursinghomecompare/search.html) features an overall star rating for each nursing home.
• Physician Compare (https://www.medicare.gov/physiciancompare/search.html) uses star ratings to display ratings for several meaningful measures for group practices.
• Dialysis Compare (https://www.medicare.gov/dialysisfacilitycompare/#search) uses star ratings to help make data on dialysis centers easier to understand and use.
• Hospital Compare (https://www.medicare.gov/hospitalcompare/search.html) uses star ratings to help consumers compare and choose among hospitals.

 

For more information on today’s announcement, please visit here: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-01-28.html.

 

For more information about the HHCAHPS Survey, please visit the official HHCAHPS Web site, here: https://homehealthcahps.org.

CMS Announces Proposed Improvements to Medicare Shared Savings Program

CMS NEWS

 

FOR IMMEDIATE RELEASE

January 28, 2016

 

Contact: CMS Media Relations

(202) 690-6145 | CMS Media Inquiries

 

CMS Announces Proposed Improvements to Medicare Shared Savings Program

Plan Strengthens Incentives for ACOs to Improve Performance

 

The Centers for Medicare & Medicaid Services (CMS) today released a proposed rule to update the methodology used to measure the performance of Accountable Care Organizations (ACOs) in the Medicare Shared Savings Program (Shared Savings Program). Today’s proposal builds on the momentum of growth in the Shared Savings Program and charts a path for long-term sustainability by improving the long-term incentives for ACOs as they continue to provide efficient, high quality health care to Medicare beneficiaries.

"Medicare payments are an important catalyst to improving care delivery, spending our resources smarter and keeping people healthy," said Andy Slavitt, Acting Administrator for CMS. "This proposal allows ACOs in all parts of the country to be successful by recognizing both their achievements and improvements in how they provide care. This should have the effect of growing the number of ACOs, and making ACOs and the coordinated care they provide to patients, more of a standard in all parts of the country."

 

Under the proposed rule, CMS would modify the process for resetting the benchmarks, which are used to determine ACO performance for ACOs renewing their participation agreements for a second or subsequent agreement period. The proposed methodology would incorporate factors based on regional fee-for-service expenditures, into establishing and updating the ACO’s rebased historical benchmark, including an adjustment to the benchmark based on regional spending that is phased-in over several agreement periods.

Key proposals include:

• Recognizing that health cost trends vary in communities across the country by using regional, rather than national, spending growth trends when establishing and updating an ACO’s rebased benchmark.
• Adjusting an ACO’s rebased benchmark when it enters a second or subsequent agreement period by a percentage (increased over time) of the difference between fee-for-service 
•  spending in the ACO’s regional service area and the ACO’s historical spending, which will provide a greater incentive for continued ACO participation and improvement.
• Giving ACOs time to prepare for benchmarks that incorporate regional expenditures by using a phased-in approach to implementation.

Other changes would include:

• Adding a participation option to facilitate an ACO’s transition to performance-based risk arrangements by allowing eligible ACOs to elect a fourth year under their existing first agreement and defer by one year entering a second agreement period under a performance-based risk track.
• Streamlining the methodology for adjusting an ACO’s benchmark when its composition changes.
• Clarifying the timeline and other criteria for reopening determinations of ACO shared savings and shared losses for good cause or fraud or similar fault.

Today’s proposals are the product of extensive stakeholder input. CMS sought comment on the methodology used to reset ACO benchmarks in a proposed rule released in December 2014. In June 2015, CMS indicated that it would pursue future rulemaking on this issue.

A fact sheet with more information about the proposed rule is available at: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-01-28-2.html

The proposed rule will be open to a 60-day comment period. The proposed rule is available for viewing at: https://www.federalregister.gov/public-inspection

Comments may be submitted by March 28, 2016 at: http://www.regulations.gov/

New Proposal to Give Providers and Employers Access to Information to Drive Quality and Patient Care Improvement

CMS NEWS

 

FOR IMMEDIATE RELEASE

January 29, 2016

 

Contact: CMS Media Relations

(202) 690-6145 | CMS Media Inquiries

 

New Proposal to Give Providers and Employers Access to Information to Drive Quality and Patient Care Improvement

MACRA provides expanded opportunity for the use of Medicare and private sector claims data to drive higher quality, lower cost care

The Centers for Medicare & Medicaid Services (CMS) today proposed rules that will expand access to analyses and data that will help providers, employers, and others make more informed decisions about care delivery. The new rules, as required by the Medicare Access and CHIP Reauthorization Act (MACRA), will allow organizations approved as qualified entities to confidentially share or sell analyses of Medicare and private sector claims data to providers, employers, and other groups who can use the data to support improved care. In addition, qualified entities will be allowed to provide or sell claims data to providers. The rule also includes strict privacy and security requirements for all entities receiving Medicare analyses or data, as well as new annual reporting requirements.

 

This initiative is part of a broader effort by the Obama Administration to create a health care system that delivers better care, spends dollars more wisely, and results in healthier people.

“Increasing access to analyses and data that include Medicare data will make it easier for stakeholders throughout the healthcare system to make smarter and more informed healthcare decisions,” said CMS Acting Administrator Andy Slavitt.

 

The qualified entity program was authorized by Section 10332 of the Affordable Care Act and allows organizations that meet certain qualifications to access to patient-protected Medicare data to produce public reports. Qualified entities must combine the Medicare data with other claims data (e.g., private payer data) to produce quality reports that are representative of how providers and suppliers are performing across multiple payers, for example Medicare, Medicaid, or various commercial payers. Currently, 13 organizations have applied and received approval to be a qualified entity.  Of these organizations, two have completed public reporting while the other 11 are preparing for public reporting.

 

Today’s rules seek to enhance the current qualified entity program to allow innovative use of Medicare data for non-public uses while ensuring the privacy and security of beneficiary information. Comments are welcome on this set of proposed rules.  You can submit your comments until March 29, 2016 here:  http://www.regulations.gov

 

 

 

 

The proposed rule is on display at the Office of the Federal Register at: https://s3.amazonaws.com/public-inspection.federalregister.gov/2016-01790.pdf  and on 02/02/2016 and available online at http://federalregister.gov/a/2016-01790

57,740 New Cancer Cases Among AANHPIs Projected in 2016

The American Cancer Society recently released a study on cancer incidence among Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPIs). Here are some key findings from the report:

·         Cancer is the leading cause of death among Asian Americans, Native Hawaiians, and Pacific Islanders.

·         Among AANHPIs in 2016, there will be an estimated 57,740 new cancer cases and 16,910 cancer deaths.

·         The most common cancer among AANHPI males is prostate (18%) and females is breast (34%).

·         AANHPIs have 30% to 40% lower overall incidence and mortality rates than non-Hispanic whites.

·         The male-to-female incidence rate ratio among AANHPIs declined from 1.43 in 1992 to 1.04 in 2012.

·         Cancer incidence in Samoan men (526.5/100,000) is more than 2x that in Asian Indian/Pakistani men.

Source: American Cancer Society, January 14, 2016

According to a recent study, 62% of male and female physicians ...

... selected patient's emotional problems as the patient factor most likely to trigger bias; weight was the second-most cited factor, by 56% of male and 48% of female physicians.

Source: "Medscape Lifestyle Report 2016: Bias and Burnout," Medscape, January 13, 2016, http://www.medscape.com/features/slideshow/lifestyle/2016/public/overview#page=7s