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Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model

Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model

by | Oct 20, 2022 | Press Release

Launched on October 1, 2018, the Bundled Payments for Care Improvement (BPCI) Advanced Model tests whether the linking of payment for a clinical episode may improve care quality while reducing Medicare price.

This month, the Centers for Medicare & Medicaid Services (CMS) announced a 2-year extension of the program, including a new opportunity for applications. Early in 2023, CMS plans to announce a request for application (RFA) to those eligible to participate in the extended years (2024–2025). For those participating in Model Year 6 and those who previously participated but are no longer active, there will be opportunity to apply for Model Year 7 (2024).

Other changes will be made to improve pricing methodology and encourage engagement among providers and suppliers, including:

  • The CMS discount for medical clinical episodes will be reduced from 3% to 2%.
  • The Peer Group Trend Factor Adjustment cap for all clinical episodes will be reduced from 10% to 5%.
  • Major joint replacement of the upper extremity (MJRUE) will be made a multi-setting clinical episode similar to the major joint replacement for the lower extremity (MJRLE) clinical episode.
  • Clinical episodes where beneficiaries are diagnosed with COVID-19 will no longer be excluded from the model.

As CMS continues to strive for better integration of primary and specialty care and cater to an increasingly complex population of beneficiaries, Econometrica is excited to continue our work supporting BPCI Advanced participants in understanding the model’s quality measure submission requirements and their performance in the model. To achieve equitable outcomes, integrated and coordinated care for beneficiaries is essential, and having a health system that is accountable, high-quality, affordable, and person-centered can help achieve that goal.

Please visit the following sites for detailed information on this topic:

Health Care Payment Learning and Action Network Summit on Nov. 9 and 10
Detailed Review for Model Extension and Changes for Model Year 6
Complete Fact Sheet for BPCI Advanced Model
More Detailed Information on BPCI Advanced

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CMS OMH Raises Awareness for National Kidney Month

CMS OMH Raises Awareness for National Kidney Month

by | Mar 17, 2022 | Econometrica Blog

National Kidney Month

The Centers for Medicare & Medicaid Services (CMS) Office of Minority Health (OMH) recognizes National Kidney Month in March by raising awareness about kidney health.

Chronic kidney disease (CKD) disproportionately affects some minority populations, including Black Americans (33 percent), American Indian/Alaska Natives (30 percent), and Hispanic Americans (28 percent).

The most common risk factors for CKD are diseases that also more heavily impact these minority populations: diabetes, which causes kidney damage due to excess sugar, and high blood pressure, which causes damage to blood vessels in the kidneys over time.

Kidneys are vital organs that filter waste out of the body. They regulate chemicals and fluid levels in the body, control blood pressure, keep bones healthy, and produce a hormone that triggers red blood cell production.

It is crucial to keep kidneys healthy. Research estimates that more than 1 in 7 adults have CKD and 9 in 10 adults who have CKD do not know that they have it. CKD is a slow-progressing disease and those affected may not have any early symptoms, so screening should be a regular occurrence, especially in those over age 65 and in minority populations.

If left untreated, CKD can eventually cause kidney failure and require a transplant.

On July 10, 2019, President Trump signed an Executive Order dedicated to advancing kidney health. For additional information about this policy, please see Econometrica’s Kidney Health Executive Order Policy Review.

For additional resources from CMS OMH related to kidney health, please visit https://www.cms.gov/About-CMS/Agency-Information/OMH/equity-initiatives/health-observances.

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Econometrica specializes in research and management across numerous industries in both the public and private sectors. We are always looking to hire the best and brightest in data science, health, grants management, energy, homeland security, housing and community development, capital markets and finance, and transportation. We work as the lead service provider, and also as a capable outsource partner to other consultancies. To work with us on your next project, visit us online and email a member of our executive staff in your preferred specialty. To explore the benefits of working for us, visit our careers page.

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January is National Poverty in America Awareness Month

by | Jan 7, 2022 | Econometrica Blog

Poverty In America

January is National Poverty in America Awareness Month, which aims to call attention to the growth of poverty in America. The COVID-19 pandemic had exacerbated the issue for families and communities nationwide.

Poverty is a complex social issue; it can manifest in hunger and malnutrition, limited access to education and other basic services, disabilities, and social discrimination and exclusion, among other ways. People living in poverty having an increased risk of chronic conditions, lower life expectancy, and barriers to receiving quality healthcare.

According to the Centers for Medicare & Medicaid Services’ (CMS) Office of Minority Health (OMH), 37.2 million Americans live in poverty, which is an increase of 3.3 million people since 2019. OMH also notes that in 2020, racial and ethnic minorities continued to be disproportionately affected by poverty, with the rates of poverty among Black (19.5%) and Hispanic (17%) Americans more than twice that of White Americans (8.2%).

CMS offers a number of resources to help  learn how to access health coverage, manage health care costs, and fully utilize benefits. For more information, visit https://www.cms.gov/About-CMS/Agency-Information/OMH/equity-initiatives/health-observances.

The Alliance for Strong Families and Communities also provides resources to combat poverty.

Work With Us, Work for Us

Econometrica specializes in research and management across numerous industries in both the public and private sectors. We are always looking to hire the best and brightest in data science, health, grants management, energy, homeland security, housing and community development, capital markets and finance, and transportation. We work as the lead service provider, and also as a capable outsource partner to other consultancies. To work with us on your next project, visit us online and email a member of our executive staff in your preferred specialty. To explore the benefits of working for us, visit our careers page.

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CMS Releases Job Aids for PAC Providers

CMS Releases Job Aids for PAC Providers

by | Nov 11, 2021 | Press Release

The Centers for Medicare & Medicaid Services (CMS) released new job aids for post-acute care (PAC) providers to aid in the assessment and coding of GG0130. Self-Care Items. T

Econometrica developed these aids under contract with CMS to “provide clinically relevant information to assist providers in understanding specific guidelines and clinical considerations that should be applied to coding GG0130. Self-Care items,” according to a CMS release.

“These job aids are a product of our collaboration with PAC providers to ensure they have resources that are useful and readily available while assessing patients,” said Kristie McNealy, Director of Health for Econometrica.

The training materials apply to four PAC settings: Home Health Agencies, Inpatient Rehabilitation Facilities, Long-Term Care Hospitals, and Skilled Nursing Facilities.

JobAids

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CMS Releases New Course for SNF Providers

CMS Releases New Course for SNF Providers

by | Aug 10, 2021 | Press Release

CMS SNF CourseBETHESDA, MD – The Centers for Medicare & Medicaid Services (CMS) released a new web-based training course that provides an overview of the assessment and coding the items in Section K related to height, weight, and nutritional approaches for skilled nursing facility residents. The on-demand, 30-minute course includes interactive exercises to test skilled nursing facility providers’ knowledge related to the assessment and coding of K0200: Height and Weight and K0510: Nutritional Approaches.

The new training was developed as part of the Post-Acute Care (PAC) Training contract, which assesses training needs, develops training materials, delivers training to providers and stakeholders, and evaluates the outcome of the trainings for changes and clarification needed due to the passing of the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act). The primary goal of the project is to deliver relevant, accurate, and engaging training to assist providers in complying with coding and data submission requirements associated with quality reporting programs (QRPs) for the skilled nursing facility, long-term care hospital, inpatient rehabilitation facility, home health agency, and hospice care settings..

The latest training can be found through the CMS’ skilled nursing facility QRP training web page.

If you have questions about accessing the course or feedback regarding the training, please email the PAC Training mailbox at PACTraining@EconometricaInc.com. Content-related questions should be submitted to the SNF QRP Help Desk at SNFQualityQuestions@cms.hhs.gov.

About Econometrica

Founded in 1998, Econometrica is a research and management organization in Bethesda, MD, established to provide public- and private-sector clients with customized program support services. Econometrica works with multiple agencies to provide high-quality, cost-effective analyses, modeling, and economic evaluations. The company consistently receives exceptional scores from its clients and believes in three principles: technical capabilities, happy customers, and business development.

 

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The new training was developed as part of the Post-Acute Care (PAC) Training contract, which assesses training needs, develops training materials, delivers training to providers and stakeholders, and evaluates the outcome of the trainings for changes and clarification needed due to the passing of the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act).