On June 3, Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma published a Health Affairs editorial article titled, “New CMS Payment Model Flexibilities For COVID-19. In a CMS fact sheet accompanying Verma’s article, the agency detailed policy changes impacting more than a dozen payment models, including: Bundled Payments for Care Improvement Advanced; Comprehensive Care for Joint Replacement; Direct Contracting; Kidney Care Choices; Medicare ACO Track 1 Plus; Next Generation ACO; Oncology Care; and Primary Care First.
For some models, the changes adjust or relax quality reporting requirements. For others, they adjust key cost benchmarks and financial reconciliation policies, while others simply offer the option to opt out of shared losses or savings for the entire 2020 performance year. Participation terms were also extended and/or delayed.
The Next Generation ACO model (scheduled to end in December) was extended another year through December 2021. Meanwhile, the Direct Contracting Model (part of the high-profile Primary Cares Initiative) will now begin April 1, 2021, instead of the previous January 1, 2021 start date. Industry stakeholders and physicians in these models largely supported these moves, aimed at bolstering continued participation in APMs during and after the pandemic. (See here and here for more details.)