Medicare

About Medicare

The federal Medicare program is an essential pillar of the state’s health care system, supporting more than 6 million Californians over the age of 65 and younger Californians with disabilities. One in five hospitals is at risk of closing, in part because Medicare reimbursement rates are far lower than the cost of providing care. It’s essential that future federal Medicare policy protects patient care.

CMS Announces New Primary Care Payment Model

What’s happening: The Centers for Medicare & Medicaid Services (CMS) announced the Accountable Care Organization (ACO) Primary Care (PC) Flex Model, a new voluntary payment model that will test how prospective payments and increased funding for primary care in ACOs impact health outcomes, quality, and costs of care.  

What else to know: CMS will launch the model on Jan. 1, 2025. 

CHA Summary: Proposed Changes for Oversight of Accrediting Organizations

What’s happening: CHA is sharing its summary of the Centers for Medicare & Medicaid Services’ (CMS) proposed rule intended to strengthen oversight of accrediting organizations (AOs) such as The Joint Commission and Det Norske Veritas.  

What else to know: While the proposed policies are applicable to AOs, several proposed changes will affect hospitals and health systems that rely on AO accreditation.  

House Passes First Package to Fund Federal Government, Includes Health Provisions

What’s happening: The U.S. House passed the Consolidated Appropriations Act of 2024, which will fund a portion of the federal government through the end of the fiscal year. The package includes a group of CHA-supported health care provisions important to hospitals.  

What else to know: Congress has until March 22 to pass a second package to fund the rest of the federal government, including the Department of Health and Human Services.  

CHA Encourages Members to Participate in the Vitality Index Payer Scorecard

What’s happening: CHA is endorsing member participation in the Vitality Index Payer Scorecard, which will provide critical information to support CHA’s advocacy to hold insurers accountable for timely and accurate reimbursement.  

What else to know: The CHA Board of Trustees has endorsed this tool, which will automatically draw de-identified claims and remittance information from hospitals without requiring additional reporting or surveys.  

CHA Provides Updated Federal Quality Measures Matrix

What’s happening: CHA has updated its federal quality measures matrix to reflect the 2024 federal fiscal year and calendar year Medicare prospective payment system final rules.   

What else to know: The matrix includes quality measures required for public reporting and performance-based programs for hospitals and post-acute care providers. 

CHA Will Host Vitality Payer Scorecard Webinar

This post has been archived and contains information that may be out of date.

What’s happening: CHA is hosting a complimentary, members-only webinar on Feb. 27 at 10 a.m. (PT) to highlight the American Hospital Association Vitality Payer Scorecard, which was recently endorsed by the CHA board.  

What else to know: The scorecard captures necessary and normalized data points without sharing protected health information. The automated process is based on de-identified claims and remittance files and eliminates the need for CHA surveys on this issue.