On October 31st the Centers for Medicare & Medicaid Services (CMS) announced the final rules defining how Medicare will pay healthcare providers and medical suppliers for fiscal year 2015.

A press release announcing the finalized rules, stated, “Important provisions of the Affordable Care Act that reward higher quality, patient-centered care at a lower cost are being implemented by these rules.” The release went on to state, “the rules reflect a broader Administration-wide strategy to move our healthcare system to one that values quality over quantity and spends taxpayer dollars more wisely by finding better ways to deliver care, pay providers, and distribute information.”

While the final rules encompass some 3000 pages, some of the key points mentioned in the press release are:

Empowering providers to deliver coordinated and integrated care, transition to new models of care, and improve the doctor-patient relationship.

  • Better coordination of care for beneficiaries with multiple chronic conditions.

Aligning the way providers are paid to reward value rather than volume.

  • Paying providers for quality, not quantity of care.
  • Providing incentives to hospital outpatient departments and facilities to deliver efficient, high-quality care.

Increasing the availability and accessibility of information on quality, utilization and costs for effective, informed decision-making.

  • Better information for providers to understand the total scope, cost, and quality of care that the Medicare beneficiaries they serve receive.
  • Expand and add new measures to the Physician Compare website.
  • New quality and performance measures for dialysis facilities.

CMS has provided a series of Fact Sheets for more information regarding the new payment rules.

Medicare payment and compliance issues regarding the Healthcare industry, especially since the passage of the Affordable Care Act, (ACA) can be quite complex. If you would like to benefit from our expertise in these areas or if you have further questions on this Advisory, do not hesitate to contact our Healthcare Specialists, or call us at 1-800-239-1474.