Annual Wellness Visits

In 2011, the Centers for Medicare and Medicaid Services (CMS) introduced Annual Wellness Visit (AWV) fee-for-service billing codes in order to encourage healthcare providers to place increased focus on preventive care. Read the VSSL AWV issue brief here. 

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Psychiatric Collaborative Care Model in Primary Care

Common mental health conditions, such as anxiety and depression, affect millions individuals and are responsible for one-quarter of all health-related disability worldwide. A growing proportion of these patients are managed in primary care settings. Recognizing the importance of broadening access to mental health services in primary care and making these services financially sustainable, the Centers for Medicare and Medicaid Services (CMS) implemented novel fee-for-service Psychiatric Collaborative Care Model (CoCM) billing codes in 2017 to reimburse health care organizations for delivering services supporting behavioral health integration, especially in primary care settings. Read the VSSL Psychiatric Collaborative Care Model in Primary Care issue brief here. 

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Cascade Care: Washington State's "Public Option" Legislation

Cascade Care is considered the nation’s first attempt at providing a public option for health insurance. Passed via WA SB 5526 in May 2019, Cascade Care includes the creation of public option insurance plans that provide a way to stabilize the individual insurance market and offer additional choice and competition in so-called “bare counties” with only one health plan on Healthplanfinder, the state’s Health Benefit Exchange (HBE). These public option plans will be offered exclusively as individual market coverage on Healthplanfinder. Read the VSSL Cascade Care issue brief here.

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Chronic Care Management

In 2015, the Centers for Medicare and Medicaid Services (CMS) launched Chronic Care Management (CCM) fee-for-service billing codes to reimburse providers for coordinating care outside of traditional office visits for patients with multiple chronic diseases. Through a team-based strategy involving physicians and other clinical staff to deliver CCM services, providers can support care management while increasing revenue. Read the VSSL CCM issue brief here.

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Direct Contracting

In January 2021, The Centers for Medicare and Medicaid Services (CMS) plans to launch its Direct Contracting (DC) payment model, a five-year program designed to foster innovative care delivery, with particular focus on primary care, by interested provider organizations. DC aims to include organizations that may not have previously been eligible for participation in CMS alternative payment model programs and to provide participants with flexibility in managing population health. Read the VSSL Direct Contracting issue brief here.

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Pathways to Success ACOs

In 2018, the Centers for Medicare and Medicaid Services (CMS) overhauled its approach to implementing accountable care organizations (ACOs) by overhauling the original Medicare Shared Savings Program (MSSP). Read the VSSL Pathways to Success MSSP issue brief here.

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Paying for and Delivering Telehealth in the Covid Era: Early Groundwork in WA Medicaid

At its initial peak, Covid-19 created immense health care disruption in Washington state and beyond. Like others across the country, providers and payers in Washington responded to these pressures by turning toward telehealth. To promote these changes and create flexibility, the Washington State Health Care Authority (HCA) implemented a number of changes that represented early groundwork for a broader telehealth payment and care delivery policy agenda for WA Medicaid. Read the VSSL Report on this topic here.

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Primary Care First

In January 2021, The Centers for Medicare and Medicaid Services (CMS) plans to launch Primary Care First (PCF), a payment model to support the delivery of advanced primary care. This voluntary five-year model aims at empowering primary care organizations to provide innovative care in 4 key areas: doctor-patient relationship; enhancing care for patients with complex and serious illness, reducing administrative burden, and focusing on financial rewards on improved health outcomes. Read the VSSL Primary Care First issue brief here.

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Primary Care Reform Intervention-Stakeholder Matrix

Despite the association between primary care and better health outcomes, growing calls for primary care reform highlight the fact that there are still opportunities to improve how primary care services are paid for, organized, and delivered to patients. Because there are many paths to this goal, a holistic stakeholder-solution perspective is a key element of effective primary care reform. Learn more or read the VSSL Primary Care Reform Intervention-Stakeholder (PRISM) white paper. 

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Transitional Care Management

In 2013, the Centers for Medicare and Medicaid Services (CMS) introduced new Transitional Care Management (TCM) billing codes as a way to better compensate outpatient primary care providers and their teams for managing care transitions after patients are discharged from hospitals. Read the VSSL TCM issue brief here.

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