New Rules:  The passage of legislation in 2018, such as the Bipartisan Budget Act of 2018 which contained provisions of the CHRONIC Care Act, will lead to changes in the types of benefits Medicare Advantage (MA) plans may offer in 2020 and beyond and what is expected of both MA and Special Needs Plans (SNPs).  CMS closed 2018 with the publication of a series of proposed and final rules that will govern MA, SNPs, and Medicaid managed care plans for 2020 and beyond. 


The researchers; Jane Zhu, Viren Patel, Judy A. Shea, Mark D. Newman, and Rachel M. Werner; found that hospitals involved in the Medicare Comprehensive Care for Joint Replacement model and the Bundled Payments for Care Improvement initiative generally followed one of two strategies with regard to skilled nursing facilities (SNFs).

As LeadingAge has highlighted in previous articles, the new BPCI-A does not permit post-acute care (PAC) providers to be episode initiators in these bundled payment models unlike the original BPCI program. Under the BPCI-A model, PAC providers can only participate by either convening a group of hospitals and physicians under BPCI-A or being a downstream provider to the BPCI-A.

The letter highlights a number of concerns about how post-acute care providers who are currently leading post-acute care (PAC) only bundles under the existing BPCI program are left with no option to continue as episode initiators under the BPCI Advanced program. The letter advocates for specific changes to CMMI’s approach and requests a meeting with CMMI to review our and the other organizations’ concerns, as well as discuss CMMI’s plans for a new PAC bundled payment program.

We also want to hear from you about what resources you need to be successful under these models. This survey is applicable to all provider types whether you are involved in a federal bundled payment program or Accountable Care Organization, a state initiative to better coordinate care, or are partnering to offer services on your HUD housing campus. Please take a 15-20 minutes today to answer a few questions as part of our member survey and help us build our knowledge. 

January was a busy month at LeadingAge, as we solidified plans for the New Year, helped members navigate a government shutdown, represented your interests on important advisory groups, and released a host of resources to help you do your work. Follow the links below to learn more.

We also want to hear from you if you are not engaged in these activities to learn why and what the barriers are for your organization.  (Please note: The primary contact for multi-site organizations may receive multiple emails with a unique link for each site or service line.)

We estimate that completing the survey will take no more than 20 minutes of your time. 

Responses will be compiled into an inventory of our members’ activities.  The inventory will help us expand our knowledge beyond anecdotes and be able to:

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