Rural Health Information Hub Latest News

CMS Announces Transformative New Model of Care for Medicare Beneficiaries with Chronic Kidney Disease

Model focuses on reducing costs and improving quality of care for patients

On September 18, CMS announced it has finalized the End-Stage Renal Disease (ESRD) Treatment Choices (ETC) Model, to improve or maintain the quality of care and reduce Medicare expenditures for patients with chronic kidney disease. The ETC Model delivers on President Trump’s Advancing Kidney Health Executive Order and encourages an increased use of home dialysis and kidney transplants to help improve the quality of life of Medicare beneficiaries with ESRD. The ETC Model will impact approximately 30 percent of kidney care providers and will be implemented on January 1, 2021 at an estimated savings of $23 million over five and a half years.

“Over the past year, the Trump Administration has taken more action to advance American kidney health than we’ve seen in decades,” said HHS Secretary Alex Azar. “This new payment model helps address a broken set of incentives that have prevented far too many Americans from benefiting from enjoying the better lives that could come with more convenient dialysis options or the possibility of a transplant.”

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CMS Announces New Guidance for Safe Visitation in Nursing Homes During COVID-19 Public Health Emergency

On September 17, CMS issued revised guidance providing detailed recommendations on ways nursing homes can safely facilitate visitation during the coronavirus disease 2019 (COVID-19) pandemic. After several months of visitor restrictions designed to slow the spread of COVID-19, CMS recognizes that physical separation from family and other loved ones has taken a significant toll on nursing home residents. In light of this, and in combination with increasingly available data to guide policy development, CMS is issuing revised guidance to help nursing homes facilitate visitation in both indoor and outdoor settings and in compassionate care situations. The guidance also outlines certain core principles and best practices to reduce the risk of COVID-19 transmission to adhere to during visitations.

See the full text of this excerpted CMS Press Release (issued September 17).

Final Evaluation of the Medicare ACO Investment Model

This week, the CMS Innovation Center released the final evaluation results of the Accountable Care Organization (ACO) Investment Model (AIM), which operated under the Shared Savings Program (SSP) from 2015 to 2018. AIM provided up-front payments to select ACOs to invest in infrastructure and staffing and targeted small ACOs, many of which were in rural areas.  Overall, participating ACOs reduced total Medicare spending and utilization without decreasing quality of care.  Read more here.

Advancing Value-Based Care in States

This week, the Centers for Medicare & Medicaid Services (CMS) released guidance to states on pathways they can use to advance value-based care, which seeks to reward providers based on quality of care instead of volume of services.   This letter describes several models that can be used across many types of payers, key features of these models, and relevant Medicaid authorities needed for adoption.  It includes several models identified in 2019 by Rural Health Value as appropriate for rural clinicians or health care delivery organizations.  Read more here.

Comments Requested: Part I of the CY 2022 Advance Notice of Medicare Advantage and Part D Payment Policies—November 13

This week, the Centers for Medicare & Medicaid Services (CMS) released earlier than usual their proposal for contract year 2022 to calculate risk scores for Medicare Advantage (MA) payments using only encounter data submitted by MA organizations and the 2020 CMS Hierarchical Conditions Categories (HCC) model.  The intent of risk adjustment is to ensure that payments to MA plans reflect the relative risk, or characteristics and health conditions, of the enrollees.  Research has found lower average risk scores for beneficiaries served by rural providers than urban, which is contrary to extensive research showing rural populations are less healthy than urban.  Read more here.

Public Health Leaders’ Testimony on Vaccinations

Last week, two of the nation’s top leaders in public health delivered testimony to the U.S. Senate Committee on Health, Education, Labor and Pensions (HELP) about the importance of immunizations for children and adults. Written testimony of NIH Director Dr. Francis Collins and Surgeon General VADM Jerome Adams is available here on the HELP Committee’s website, and you may watch a recording of the full three-hour session.  Read more here.

CDC: Delay or Avoidance of Medical Care Because of COVID-19-Related Concerns

In its latest Morbidity and Mortality Weekly Report, the Centers for Disease Control and Prevention (CDC) presents findings of a survey conducted in June of this year. Researchers estimate that 41 percent of U.S. adults had delayed or avoided medical care because of concerns about COVID-19.  Avoidance of urgent or emergency care was more prevalent among unpaid caregivers for adults, persons with underlying medical conditions, Black adults, Hispanic adults, young adults, and persons with disabilities.  The findings indicate missed opportunities for management of chronic conditions, receipt of routine vaccinations, or early detection of new conditions, which might worsen outcomes.  Read more here.

HHS Strategy to Distribute COVID-19 Vaccine

The U.S. Department of Health and Human Services (HHS) released its strategy to distribute a COVID-19 vaccine after one has received approval from the Food and Drug Administration.  It focuses on four key tasks necessary to ensure access and the requirements for each.  The primary task is to engage with state, tribal, territorial, and local partners, other stakeholders, and the public to communicate public health information, before and after distribution begins.  Read more here.