The Centers for Medicare and Medicaid Services is testing two new financial models designed to achieve improved quality and decreased costs through better coordination of care for Medicare and Medicaid beneficiaries, according to a CMS fact sheet.
The goal of the new models is to increase the number of Medicare and Medicaid enrollees receiving care from coordinated systems due to the potential for higher quality and reduced costs. To reach this goal, the new models align the finances of the Medicare and Medicaid programs.
The Capitated Model involves a three-way contract between a state, CMS and a health plan, which receives a prospective blended payment to provide comprehensive, coordinated care. The Managed Fee-for-Service Model involves an agreement between a state and CMS in which the state could gain savings from initiatives that improve quality and lower costs for Medicare and Medicaid.
The CMS Center for Medicare and Medicaid Innovation will test these models for their effects on cost and quality of care for Medicare and Medicaid enrollees. States may apply to participate in either or both of the new models.
Read the CMS fact sheet on the new financial models.
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CMS Issues CY 2012 Outpatient Prospective Payment System Proposed Rule
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The goal of the new models is to increase the number of Medicare and Medicaid enrollees receiving care from coordinated systems due to the potential for higher quality and reduced costs. To reach this goal, the new models align the finances of the Medicare and Medicaid programs.
The Capitated Model involves a three-way contract between a state, CMS and a health plan, which receives a prospective blended payment to provide comprehensive, coordinated care. The Managed Fee-for-Service Model involves an agreement between a state and CMS in which the state could gain savings from initiatives that improve quality and lower costs for Medicare and Medicaid.
The CMS Center for Medicare and Medicaid Innovation will test these models for their effects on cost and quality of care for Medicare and Medicaid enrollees. States may apply to participate in either or both of the new models.
Read the CMS fact sheet on the new financial models.
Related Articles on Medicare and Medicaid Finances:
CMS Issues CY 2012 Outpatient Prospective Payment System Proposed Rule
CMS Issues Physician Fee Schedule Proposed Rule
Physicians' Medicare Payments May be Cut 29.4%