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Continued from page 8 ALTERNATIVE PAYMENT MODELS IN HEALTHCARE


The Centers for Medicare and Medicaid Services has introduced several alternative pay models designed to reduce costs and improve care. A few options are listed here.


2010 Multi-Payer Advanced Primary Care Model - Medicare partnership with commercial payers in select states. Provides monthly care management fees to test outcomes of advanced primary care.


2011


End-Stage Renal Disease Prospective Payment System - Provides single payment for dialysis services at a facility or in patients' homes. Mandated by the Medicare Improvements for Patients and Providers Act of 2008.


2012


Comprehensive Primary Care Initiative - Transforms primary care practices with non-visit-based payments, data feedback and learning systems for physicians and other clinicians.


Medicare Shared Savings Program - Created by the Affordable Care Act to help Medicare fee-for-service providers become accountable care organizations, an alternative-payment model with greater financial reward and more financial risk. Saved Medicare $300 million in 2014.


Pioneer ACOs - Created for early coordinated care adopters. Have been integrated into the Medicare Shared Savings Program. Saved $100 million in 2014.


2013


Bundled Payments Care Improvement - Targets 48 conditions with a single payment for a care episode. More than 1,700 acute-care hospitals, skilled nursing facilities, physician group practices, long-term care hospitals, inpatient rehabilitation facilities, home health agencies and others assume financial risk.


2014


Maryland All-Payer Model - The state of Maryland adopted this system which pays hospitals a fixed amount for inpatient and outpatient services, regardless of the number of patients treated. Saved Medicare $116 million during first year.


2015


Comprehensive End-Stage Renal Disease Care Model - Dialysis facilities, nephrologists and nephrology group practices and others assumes risks and potential rewards for coordinating patient care.


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Medicare Choices Model - Provides new options for hospice patients, allowing palliative care and curative care at the same time. Hospices received a $400 per-beneficiary-per-month fee.


2016


Next Generation ACOs - Designed for experienced ACOs. Allows providers to assume higher risk and reward levels than available with the current Pioneer ACO and Medicare Shared Savings Program.


Source: Centers for Medicare and Medicaid Services


the program most helpful to medical providers, Paulk said. Existing state licensure allows its Florida locations to provide more medical services, another asset to promote to potential partners. Paulk, a former nurse, was well aware of what data doctors would find very beneficial. She marketed the


statistics that Arbor tracked, rather than trying to track all the information hospitals do. Arbor's leaders didn’t attempt to change the company’s services and focus; they showed how they could be good partners in their existing business model. They did, however, make a small change.


Continued on page 12 10 SENIOR LIVING EXECUTIVE / JULY/AUGUST 2016


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