Medicare Access and Chip Reauthorization Act (MACRA)

The Medicare Access and Chip Reauthorization Act has now replaced the Medicare Sustainable Growth Rate, starting January 1 of 2017. The legislation identifies two different payment tracks, Merit Based Incentive Payments (MIPS) and Advanced Alternative Payment Models (APMs), which will determine the payment received for Medicare Part B payments in 2019 and beyond. For more information click below.

 

MACRA Educational Webinar

 

 

CMS: Quality Payment Program

 

Patient Centered Medical Home (PCMH)

According to Blue Cross Blue Shield of Michigan (BCBSM), the BCBSM Patient‐Centered Medical Home Designation Program is a component of BCBSM’s Physician Group Incentive Program (PGIP). PGIP is designed to facilitate practice transformation, and to reward Physician Organizations (POs) for improved performance in health care delivery. Since PGIP’s inception in 2005, POs have been working on practice improvement and participating in initiatives that reward improved quality, utilization and efficiency performance. See additional information about the BCBMS PCMH program below.

PCMH Participation Guide

BCBSM Value Partnerships

 

State Innovation Model (SIM)

According to the Michigan Department of Health and Human Services, The State Innovation Model focuses on the development and testing of multi-payer health care payment and service delivery models in order to achieve better care coordination, lower costs, and improved health outcomes for Michiganders. The Affinia Health Network – Lakeshore region was selected as one of five regions in the State of Michigan to pilot this innovative comprehensive approach. Please see the links below for more information.

State Innovation Model

 

Michigan Blueprint for Health

According to the Michigan Department of Health and Human Services,the Blueprint for Health Innovation is a strategic plan developed in collaboration with a wide variety of health care stakeholders, including representatives of health systems, physicians, payers, business, safety net providers, community service providers and consumers. The Blueprint for Health Innovation is built upon five components:

  1. Patient-Centered Medical Homes
  2. Accountable Systems of Care
  3. Value-Based Payment Models
  4. Community Health Innovation Regions
  5. Enhanced Data-Sharing and Interoperability

For more information about this important work in the state of Michigan, click the link below.

Blueprint for Health Innovation