CMMI Payment Model Flexibilities in Response to COVID-19

By Blair Childs, Senior Vice President, Public Affairs

Premier applauds the Centers for Medicare & Medicaid Services (CMS) for providing guidance on how it will mitigate COVID-19 impact on Innovation Center models. These changes provide urgently needed relief for healthcare providers in advanced alternative payment models (APMs) that bear a significant amount of risk.

We appreciate that CMS has adopted many of Premier’s recommendations, including adopting similar policies across all models by removing COVID-19 episodes from expenses as well as tailored modifications to specific Innovation Center models. These modifications include mitigating losses for Next Generation ACOs by the percentage of months in a public health emergency and extending the model one year, allowing participants of bundled payment models the option to be excluded from payment reconciliation for 2020, and providing an opportunity for entities to enter Direct Contracting with an April 1, 2021 start date.

We’ve found that providers participating in alternative payment models were better prepared and able to ramp up care management, call centers and remote/home monitoring and other capabilities to respond to COVID-19. These changes will enable participants to stay in the models so that we do not loose progress in the movement to value-based care. We look forward to continuing to work with CMS as more details of these new policies are developed and to ensure the long-term success of these models.