« The Dual Agenda: April 6, 2016 Issue

Noteworthy News

CMS Releases Behavioral Health Parity Rule

The Centers for Medicare and Medicaid Services (CMS) has finalized the long-awaited rule applying mental health and substance use disorders parity to Medicaid and the Children’s Health Insurance Program (CHIP). Readers can view the full text of the rule or look at CMS’ fact sheet for highlights.

Bundled Payment Models for Joint Replacements Take Off

On April 1, the Centers for Medicare and Medicaid Services (CMS) began its far-reaching experiment to apply a bundled payment model to hip and joint replacements in 67 metropolitan areas across the country. Medicare will begin to measure the cost for a hospital's joint replacement patients against a set target that factors in savings to the program. Depending on how a hospital performs on cost and quality targets, it could get a bigger payment from Medicare, or might eventually have to pay back money. Hospitals will be able to share bonuses with rehab centers and other providers, creating an incentive to work together. In related news, the New England Journal of Medicine Catalyst reports on an independent orthopedic physician group in North Carolina that has implemented a bundled payment program for joint replacement surgery.

Effective Engagement of Patients and Caregivers

Dr. Ann Hwang, Director of the Center for Consumer Engagement in Health Innovation, co-authored an article on innovations to more effectively engage patients and caregivers. The article surveys a number of promising studies that look at different ways of exploring the opportunities and challenges of patient-centered engagement programs.

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