CMS: New Payment Model Flexibilities in Response to COVID-19

June 4, 2020

In response to the COVID-19 pandemic, the Centers for Medicare & Medicaid Services (CMS) has announced new flexibilities and adjustments to current and future value-based payment models implemented by the Center for Medicare and Medicaid Innovation (CMMI). According to CMS, the flexibilities and changes were determined using the following principles:

  • Utilize flexibilities that already exist in current model design;
  • Continue sufficient financial incentives that encourage higher quality outcomes to participate in value based arrangements;
  • Ensure equity and consistency across models;
  • Align with national value based and quality payment programs;
  • Minimize risk to model participants, the Medicaid program, and the Medicare Trust Funds;
  • Minimize delays in new model implementation while providing additional opportunities for participation in new models;
  • Minimize reporting burden; and
  • Complement and build off of new CMS COVID-19 flexibilities as outlined in regulation and waivers.

CMS outlines these flexibilities by model in a table that provides details on financial methodology, quality reporting and model timeline changes for 16 CMMI models, including the Bundled Payments for Care Improvement Advanced, Maternal Opioid Misuse Model and the Oncology Care Model.

CMS notes that these flexibilities supplement emergency rules and waivers granted under section 1135 of the Social Security Act that specifically address the COVID-19 public health emergency. Additional information can be found here