The Centers for Medicare & Medicaid Services (CMS) Innovation is launching a new payment model that aims to give a boost to Americans’ access to quality rural healthcare and telehealth services, and to shift U.S. healthcare providers toward more value-based payments.
Specifically, the agency announced on August 11 that the new Community Health Access and Rural Transformation (CHART) Model will help build better healthcare systems by providing up-front investments and capitated payments to healthcare organizations in these rural areas.
Coronis Health is well-prepared for the new payment model implementation for our rural healthcare facilities clients. As a global company that is committed to providing personal, high-touch service, we seek a level of professionalism and analysis you won’t find elsewhere. With 100+ years of combined experience, we can provide cost-effective and fast services to help rural facilities thrive and serve their communities better. We don’t just help you get payments, but we will also help you maintain financial independence and cultivate financial success.
What is the Community Health Access and Rural Transformation (CHART) Model?
From limited transportation options to shortages in healthcare services, Americans living in rural communities face unique needs and challenges when seeking healthcare services. As a result, rural Americans (approximately 57 million) will face worse health outcomes compared to those residing in larger metropolitan areas. According to CMS, it is the goal of the CHART Model to help address these disparities by providing a way for rural communities to transform their healthcare delivery systems by leveraging innovative financial arrangements as well as operational and regulatory flexibilities.
The objectives of the Model are:
- To increase the financial stability for rural providers through more innovative ways of reimbursing providers that provide up-front investments and predictable, capitated payments that pay for quality and patient outcomes
- To remove the regulatory burden by providing waivers that increase operational and regulatory flexibility for rural providers
- To enhance the beneficiaries’ access to healthcare services by ensuring rural providers remain financially sustainable for years to come and to offer additional services such as those that address social determinants of health (e.g., food and housing)
The new Model will include two options for participation (as stated by CMS). To learn more about the CHART model, visit cms.gov
1. The Community Transformation Track
CMS will select up to 15 Lead Organizations for this track. A Lead Organization is a single entity that represents a rural community, comprised of either (a) a single county or census tract or (b) a set of contiguous or non-contiguous counties or census tracts. Examples of entities eligible to serve as Lead Organizations include, but are not limited to, state Medicaid agencies, State Offices of Rural Health, local public health departments, Independent Practice Associations, and Academic Medical Centers.
Lead Organizations will be responsible for working closely with key model participants (e.g., including Participant Hospitals and the state Medicaid agency) and driving healthcare delivery system redesign by leading the development and implementation of Transformation Plans with their community partners. The Transformation Plan is a detailed description that outlines the community’s plan to implement the healthcare delivery redesign strategy.
Lead Organizations and their community partners will receive upfront cooperative agreement funding, financial flexibilities through a predictable capitated payment amount (CPA) for Participant Hospitals in a community, and operational and regulatory flexibilities.
2. ACO Transformation Track
CMS will select up to 20 rural-focused ACOs to receive advanced payments as part of joining the Medicare Shared Savings Program (Shared Savings Program). Building on the success of the ACO Investment Model (AIM), the advanced shared savings payments are expected to help CHART ACOs engage in value-based payment efforts that will improve outcomes and quality of care for rural beneficiaries. A CHART ACO will be able to receive the following shared savings payments:
- A one-time upfront payment equal to a minimum of $200,000 plus $36 per beneficiary to participate in the 5-year agreement period in the Shared Savings Program.
- A prospective per beneficiary per month (PBPM) payment equal to a minimum of $8 for up to 24 months.
CMS anticipates the Notice of Funding Opportunity (NOFO) for the Community Transformation Track will be available in September on the Model website. The Request for Application (RFA) for the ACO Transformation Track will be available in early 2021.
The CMS plans to select up to 20 rural ACOs to participate in the ACO transformation track in fall 2021, with the first performance period beginning in January 2022. Up to 15 rural communities will also be selected to participate in the community transformation track in early 2021, and the first performance period will begin in July 2022.
How Can Coronis Health Assist You With These Changes?
Coronis Health offers specialized financial and medical billing solutions to not just all types of hospitals and surgical centers, but rural community facilities, specifically. We understand how you provide vital care for communities across the country and how it can be a struggle to keep your doors open or to keep enough staff.
Our team is constantly vigilant and compliant amid the changes that take place in governmental/carrier billing and documentation regulations, compliance requirements, and new payment models. We strive to be not just a vendor for our clients but a true resource. Our clients know that if they have a question or need advice around the revenue cycle, we’re always there to help. We provide monthly education sessions for our providers in addition to one-on-one coaching around specific claims.
Our team goes above and beyond to ensure our rural healthcare facilities clients are receiving the best performance from our team. We constantly search for ways to improve our processes to ensure your revenue cycle is performing at the highest level. We are also proud to be fully transparent in our work. We provide regular reporting and analytics so our rural healthcare facilities clients can be confident knowing exactly what’s happening with their revenue cycle at all times. Coronis works diligently to be proactive in alerting clients of potential challenges as well as making suggestions on how to be more profitable.
Schedule an Appointment to See How We Can Reduce Your Rural Healthcare Clinic Costs Today
We support the goal of empowering rural communities to create a system that will deliver high-quality healthcare services to patients by supporting providers through more efficient payment structures. We can help you navigate these new changes and help meet the needs of your practice. To learn more, contact Coronis Health and schedule a consultation.