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CMS Announces New Initiative

The Centers for Medicare & Medicaid Services (CMS) has announced a new initiative to improve the clinician experience with the Medicare program. Acting Administrator Andy Slavitt is appointing Dr. Shantanu Agrawal to lead the development of this function and its implementation, which will cover documentation requirements and existing physician interactions with CMS, among other aspects of provider experiences. To ensure CMS is hearing from practicing physicians, each of the ten CMS regional offices will oversee local meetings to take input from physician practices within the next six months, with regular meetings thereafter.

The first action is the launch of an 18-month pilot program to reduce medical review for certain physicians while continuing to protect program integrity. Under the program, providers practicing within specified Advanced Alternative Payment Models (APMs) will be relieved of some scrutiny under certain medical review programs. Advanced APMs were identified as a potential opportunity for this pilot because participating clinicians share financial risk with the Medicare program. Two-sided risk models provide powerful motivation to deliver care in the most efficient manner possible, greatly reducing the risk of improper billing for services. After the results of the pilot are analyzed, CMS will consider expansion along various dimensions including additional Advanced APMs, specialties, and provider types.

For more information, visit https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-10-13.html

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