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CMS Development of “Serious Illness” Care Model Continues to Advance

Posted on Sunday, January 13, 2019 5:47 PM

There is a gap in Medicare coverage relating to effectively treating beneficiaries with serious chronic or advanced illnesses.  The key to treating these beneficiaries successfully is to offer team-based, patient-centered care aimed at maintaining maximum function, managing pain and minimizing acute exacerbations.

Over recent years, CMS and federal legislators have advocated for advancements in this critical area.  “Recent indications are that CMS’ Center for Medicare and Medicaid Innovation (CMMI) is making headway in developing just such a model in the form of a Physician-Focused Payment Model using proposals that were crafted by the Coalition to Transform Advanced Care (C-TAC) and the American Academy of Hospice and Palliative Medicine (AAHPM).  As part of a recently-issued fact sheet on value considerations for model development and testing of models that have been recommended by the Physician-Focused Payment Model Technical Advisory Committee (PTAC), CMMI formally confirms that it is working on this model.  The fact sheet further outlines in broad terms the considerations CMMI will use to assess and develop models recommended by PTAC for testing.”

Source: NAHC

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