Medical Economics April 30, 2024
Jeffrey Bendix

Request to CMS is prompted by unexpected spike in catheter prices from some suppliers

A coalition of 11 groups representing accountable care organizations (ACOs) and other health care stakeholders wants the government not to consider “anomalous” Medicare spending that is outside ACOs’ members control when determining if an ACO has exceeded its annual spending benchmarks

In a letter to Chiquita Brooks-LaSure, administrator of the Centers for Medicare and Medicaid Services (CMS), the coalition members acknowledged CMS’s recent efforts to promote value-based care. They added, however, that including unusually high claims penalizes ACOs and jeopardizes participation of doctors, medical practices, and other health care organizations in them.

The letter was prompted by a spike in spending on two catheter codes, from...

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Topics: ACO (Accountable Care), CMS, Govt Agencies, Insurance, Medicare, Payment Models, Primary care, Provider, Value Based
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