The CMS Innovation Center held the fourth in a series of webinar events for the Comprehensive End-Stage Renal Disease (ESRD) Care (CEC) Model on Wednesday, June 29, 2016 from 4:00p.m. – 5:00p.m. EDT. This webinar explored the LDO and non-LDO financial methodologies and the quality measures that are part of this model.
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Staff from the CMS Innovation Center hosted an overview webinar of the Health Care Innovation Awards Round Two to give interested potential applicants the opportunity to hear more about the Funding Opportunity Announcement. CMS Innovation Center staff were also available to answer questions. Advance registration was required.
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CMS Innovations
http://innovations.cms.gov
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The CMS Innovation Center held the second in a series of webinar events for the Comprehensive End-Stage Renal Disease (ESRD) Care (CEC) Model on Wednesday, June 8, 2016 from 12:00p.m. – 1:30p.m. EDT. This webinar consisted of a panel discussion focusing on learning from past ESCO participants on what it takes to become a successful applicant and successful ESCO.
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CMS Innovation Center
http://innovation.cms.gov
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The Center for Medicare & Medicaid Innovation (CMS Innovation Center) hosted an open door forum providing a application overview for the 2017 Next Generation Accountable Care Organization Model. The open door forum washeld on Tuesday, March 29 from 4:00pm – 5:30pm EDT.
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CMS Innovation Center
http://innovation.cms.gov
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The CMS Innovation Center hosted a repeat of the Thursday, November 6 ACO Investment Model webinar on Tuesday, November 18, 2014, from 2:30pm-3:30pm EST. The webinar provided guidance on the ACO Investment Model (AIM) application to prospective ACO applicants. The webinar included a review of the model eligibility requirements and an explanation of each application question including the spend plan narrative and spreadsheet.
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CMS Innovation Center
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The Kidney Care Choices (KCC) Model team hosted a Comprehensive Kidney Care First (KCF) Model Option introduction webinar on Friday, November 15, 2019 from 12:00 p.m. - 1:00 p.m. EST.
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CMS Innovation Center
http://innovation.cms.gov
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During this webinar the Direct Contracting Model Options team hosted a webinar on Wednesday, December 18, 2019 from 1:30 p.m.- 3:00 p.m. EST. During this webinar, presenters provided information about benefit enhancements for the Direct Contracting Model Options.
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CMS Innovation Center
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The Center for Medicare & Medicaid Innovation (CMS Innovation Center) hosted the first of two webinars on November 19 to describe the final rule and respond to questions about the Comprehensive Care for Joint Replacement Model.
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CMS Innovation Center
http://innovation.cms.gov
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The Million Hearts: Cardiovascular Disease Risk Reduction Model team hosted an open door forum on Thursday, September 3, 2015. Attendees received an overview of the application as well an opportunity for question and answers about the Model. Joining the team was Paul Meissner, Director of Research Program Development at Montefiore Medical Center, who talked about why the Model is important to his organization.
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CMS Innovation Center
http://innovation.cms.gov
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Staff from the CMS Innovation Center hosted an overview webinar of the Health Care Innovation Awards Round Two to give interested potential applicants the opportunity to hear more about the Funding Opportunity Announcement. CMS Innovation Center staff were also available to answer questions. Advance registration was required.
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CMS Innovations
http://innovations.cms.gov
We accept comments in the spirit of our comment policy:
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The CMS Innovation Center held the second in a series of webinar events for the Comprehensive End-Stage Renal Disease (ESRD) Care (CEC) Model on Wednesday, June 8, 2016 from 12:00p.m. – 1:30p.m. EDT. This webinar consisted of a panel discussion focusing on learning from past ESCO participants on what it takes to become a successful applicant and successful ESCO.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The Center for Medicare & Medicaid Innovation (CMS Innovation Center) hosted an open door forum providing a application overview for the 2017 Next Generation Accountable Care Organization Model. The open door forum washeld on Tuesday, March 29 from 4:00pm – 5:30pm EDT.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
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The CMS Innovation Center hosted a repeat of the Thursday, November 6 ACO Investment Model webinar on Tuesday, November 18, 2014, from 2:30pm-3:30pm EST. The webinar provided guidance on the ACO Investment Model (AIM) application to prospective ACO applicants. The webinar included a review of the model eligibility requirements and an explanation of each application question including the spend plan narrative and spreadsheet.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
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The Kidney Care Choices (KCC) Model team hosted a Comprehensive Kidney Care First (KCF) Model Option introduction webinar on Friday, November 15, 2019 from 12:00 p.m. - 1:00 p.m. EST.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
During this webinar the Direct Contracting Model Options team hosted a webinar on Wednesday, December 18, 2019 from 1:30 p.m.- 3:00 p.m. EST. During this webinar, presenters provided information about benefit enhancements for the Direct Contracting Model Options.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
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The Center for Medicare & Medicaid Innovation (CMS Innovation Center) hosted the first of two webinars on November 19 to describe the final rule and respond to questions about the Comprehensive Care for Joint Replacement Model.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
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The Million Hearts: Cardiovascular Disease Risk Reduction Model team hosted an open door forum on Thursday, September 3, 2015. Attendees received an overview of the application as well an opportunity for question and answers about the Model. Joining the team was Paul Meissner, Director of Research Program Development at Montefiore Medical Center, who talked about why the Model is important to his organization.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
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The Emergency Triage, Treat, and Transport (ET3) Model Medical Triage Line Notice of Funding Opportunity (NOFO) webinar provided an overview of the application process and NOFO requirements for implementing 911 medical triage lines. This webinar was intended for those interested in learning more about the ET3 Model’s Notice of Funding Opportunity, which was released March 12.
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CMS Innovation Center
http://innovation.cms.gov
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The CMS Innovation Center offered a kickoff webinar event for the Comprehensive End-Stage Renal Disease (ESRD) Care (CEC) Model on Tuesday, May 31, 2016 from 4:00–5 p.m. EDT. This webinar focused on model objectives, terms of the award, eligibility criteria, changes from the first public solicitation and important deadlines. A 20 minute question and answer period followed the presentation.
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CMS Innovation Center
http://innovation.cms.gov
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http://newmedia.hhs.gov/standards/comment_policy.html
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The Center for Medicare & Medicaid Services hosted a webinar on Thursday, April 14, 2016. During this webinar staff provided an overview of the model. A repeat of the webinar was held on Tuesday, April 19.
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CMS Innovation Center
http://innovation.cms.gov
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The CMS Innovation Center hosted a webinar on Tuesday, February 11, 2014 from 2:30 – 4:30pm EST that provided an overview of the demonstration and the application package.
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CMS Innovation Center
http://innovation.cms.gov
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In this webinar, staff from the CMS Innovation Center provided an overview of the Demonstration, and offered information about how to apply.
More at: http://www.innovations.cms.gov/resources/GNE_overview.html
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
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The Medicare-Medicaid Accountable Care Organization Model team hosted a webinar for states that are participating in the Medicare-Medicaid ACO Model on Thursday, June 15, 2017. Participating states have the opportunity to share in Medicare savings generated by Medicare-Medicaid ACOs in their state. This webinar covered the methodology for calculating those shared savings.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
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The CMS Innovation Center hosted a webinar on Tuesday, March 4, 2014 to discuss the Winter Open Period. This webinar included available information about the models, as well as the process and requirements for submitting requests for participation.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
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The CMS Innovation Center hosted a webinar on Monday, March 3, 2014 to provide information on how to calculate budget neutrality for the five prongs in the Frontier Community Health Integration Project Demonstration. CMS also provided examples of ways that applicants can respond to the solicitation. Subject matter experts from the CMS Innovation Center and the Health Resources Services Administration (HRSA) provided details and answered questions.
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CMS Innovation Center
http://innovation.cms.gov
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The Medicare-Medicaid Accountable Care Organization (ACO) Model team hosted a webinar on Thursday, June 8, 2017 that covered the high-level processes for assigning beneficiaries to Medicare-Medicaid ACOs and calculating savings/losses generated by Medicare-Medicaid ACOs. The webinar also covered the role of participating states in designing the details of these methodologies.
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CMS Innovation Center
http://innovation.cms.gov
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The CMS Innovation Center hosted a webinar on Wednesday April 9, 2014 to provide an overview of the Medicare Care Choices Model and the application process. Subject matter experts from the CMS Innovation Center provided details and answered questions.
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CMS Innovation Center
http://innovation.cms.gov
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The Center for Medicare & Medicaid Innovation hosted an Open Door Forum (ODF) to allow dialysis facilities, nephrologists, other Medicare providers of services, suppliers, and other interested parties to ask questions on the revisions to the Request for Application (RFA) for the Comprehensive End Stage Renal Disease (ESRD) Care Initiative that was released on April 15, 2014.
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CMS Innovation Center
http://innovation.cms.gov
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On Thursday, April 18 from 1:00 p.m. - 2:00 p.m. EDT the Artificial Intelligence (AI) Health Outcomes Challenge team provided an informational overview of the challenge.
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CMS Innovation Center
http://innovation.cms.gov
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This was the second event in a two-part webinar series on the Primary Care First Seriously Ill Population (SIP) payment model option. During this webinar, the Primary Care First Model Options team reviewed additional details about the SIP payment model option. This webinar built upon what was discussed during the first SIP webinar held on July 24, 2019 and provided an opportunity for attendees to submit live questions.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
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The CMS Innovation Center held the second in a series of webinars for potential applicants to Health Care Innovation Awards Round Two. The webinar held Wednesday, June 12, 2013 1:30pm – 3:00pm EDT, focused specifically on the first two of the four innovation categories.
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CMS Innovations
http://innovations.cms.gov
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The CMS Innovation Center hosted a special webinar featuring Dr. Patrick Conway, CMS Deputy Administrator for Innovation and Quality and CMS Chief Medical Officer, on Monday, November 10, 2014 from 10:30am – 11:30 am ET. Dr. Conway will provided an update about the work of the CMS Innovation Center and the models being tested to improve better care for patients, better health for our communities, and lower costs through improvement for our health care system. Opportunities for questions were provided.
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CMS Innovation Center
http://innovation.cms.gov
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The Next Generation ACO Model team hosted an open door forum on Tuesday, February 28, 2017. During this open door forum Model team members provided a deep dive presentation examining details of financial aspects relating to the model.
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CMS Innovation Center
http://innovation.cms.gov
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The Center for Medicare and Medicaid Innovation hosted a webinar on Thursday, October 8, 2015. The webinar provided an opportunity to learn more about efforts to solicit public comment on a variety of alternative payment pathways to increase value over volume.
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CMS Innovation Center
http://innovation.cms.gov
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In follow-up to the March 10, 2015 announcement of the Next Generation Accountable Care Organization (ACO) Model of payment and care delivery, the Center for Medicare and Medicaid Innovation (CMS Innovation Center) hosted a repeat of the first open door forum in a series focusing on various aspects of the Model.
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CMS Innovation Center
http://innovation.cms.gov
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The Primary Care First (PCF) Model Options team hosted a series of four informational webinars about the PCF Model Options. Topics discussed included the model options' aims, requirements, benefits of participation, and application next steps. Attendees had the opportunity to submit questions to the model options team during each of the webinars. Each of the webinars covered the same information.
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CMS Innovation Center
http://innovation.cms.gov
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The Center for Medicare & Medicaid Innovation (CMS Innovation Center) hosted an open door forum providing letter of intent overview for the 2017 Next Generation Accountable Care Organization Model. The open door forum was held on Tuesday, March 22 from 4:00pm – 5:30pm EDT.
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CMS Innovation Center
http://innovation.cms.gov
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CMS hosted an Open Door Forum call on November 22, 2013 to allow providers, suppliers, beneficiary advocacy groups, and other interested parties to provide input into the design and implementation of this demonstration. Mandated by the “Medicare IVIG Access and Strengthening Medicare and Repaying Taxpayers Act of 2012 (P.L. 112-242)”, the purpose of this demonstration is to evaluate the impact of providing payment for items and services needed for the in-home administration of IVIG for the treatment of primary immune deficiency disease (PIDD). The demonstration will provide these benefits for up to 4,000 Medicare beneficiaries for a period of three years.
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CMS Innovations
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In this August 15, 2012 webinar CMS Innovation Center staff provided additional information for states that are interested in applying for a Model Testing award. Governors' offices were strongly encouraged to onvite their health care innovation team, key stakeholders and appropriate State officials such as State health department directors, Medicaid directors, and insurance commissioners.
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CMS Innovations
http://innovations.cms.gov
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The Emergency Triage, Treat, and Transport (ET3) Model Medical Triage Line Notice of Funding Opportunity (NOFO) webinar provided an overview of the application process and NOFO requirements for implementing 911 medical triage lines. This webinar was intended for those interested in learning more about the ET3 Model’s Notice of Funding Opportunity, which was released March 12.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
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The CMS Innovation Center offered a kickoff webinar event for the Comprehensive End-Stage Renal Disease (ESRD) Care (CEC) Model on Tuesday, May 31, 2016 from 4:00–5 p.m. EDT. This webinar focused on model objectives, terms of the award, eligibility criteria, changes from the first public solicitation and important deadlines. A 20 minute question and answer period followed the presentation.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
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The Center for Medicare & Medicaid Services hosted a webinar on Thursday, April 14, 2016. During this webinar staff provided an overview of the model. A repeat of the webinar was held on Tuesday, April 19.
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CMS Innovation Center
http://innovation.cms.gov
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The CMS Innovation Center hosted a webinar on Tuesday, February 11, 2014 from 2:30 – 4:30pm EST that provided an overview of the demonstration and the application package.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
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In this webinar, staff from the CMS Innovation Center provided an overview of the Demonstration, and offered information about how to apply.
More at: http://www.innovations.cms.gov/resources/GNE_overview.html
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
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CMS Privacy Policy
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The Medicare-Medicaid Accountable Care Organization Model team hosted a webinar for states that are participating in the Medicare-Medicaid ACO Model on Thursday, June 15, 2017. Participating states have the opportunity to share in Medicare savings generated by Medicare-Medicaid ACOs in their state. This webinar covered the methodology for calculating those shared savings.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The CMS Innovation Center hosted a webinar on Tuesday, March 4, 2014 to discuss the Winter Open Period. This webinar included available information about the models, as well as the process and requirements for submitting requests for participation.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
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The CMS Innovation Center hosted a webinar on Monday, March 3, 2014 to provide information on how to calculate budget neutrality for the five prongs in the Frontier Community Health Integration Project Demonstration. CMS also provided examples of ways that applicants can respond to the solicitation. Subject matter experts from the CMS Innovation Center and the Health Resources Services Administration (HRSA) provided details and answered questions.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
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The Medicare-Medicaid Accountable Care Organization (ACO) Model team hosted a webinar on Thursday, June 8, 2017 that covered the high-level processes for assigning beneficiaries to Medicare-Medicaid ACOs and calculating savings/losses generated by Medicare-Medicaid ACOs. The webinar also covered the role of participating states in designing the details of these methodologies.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
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CMS Privacy Policy
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The CMS Innovation Center hosted a webinar on Wednesday April 9, 2014 to provide an overview of the Medicare Care Choices Model and the application process. Subject matter experts from the CMS Innovation Center provided details and answered questions.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
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CMS Privacy Policy
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The Center for Medicare & Medicaid Innovation hosted an Open Door Forum (ODF) to allow dialysis facilities, nephrologists, other Medicare providers of services, suppliers, and other interested parties to ask questions on the revisions to the Request for Application (RFA) for the Comprehensive End Stage Renal Disease (ESRD) Care Initiative that was released on April 15, 2014.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
On Thursday, April 18 from 1:00 p.m. - 2:00 p.m. EDT the Artificial Intelligence (AI) Health Outcomes Challenge team provided an informational overview of the challenge.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
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CMS Privacy Policy
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This was the second event in a two-part webinar series on the Primary Care First Seriously Ill Population (SIP) payment model option. During this webinar, the Primary Care First Model Options team reviewed additional details about the SIP payment model option. This webinar built upon what was discussed during the first SIP webinar held on July 24, 2019 and provided an opportunity for attendees to submit live questions.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The CMS Innovation Center held the second in a series of webinars for potential applicants to Health Care Innovation Awards Round Two. The webinar held Wednesday, June 12, 2013 1:30pm – 3:00pm EDT, focused specifically on the first two of the four innovation categories.
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CMS Innovations
http://innovations.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
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The CMS Innovation Center hosted a special webinar featuring Dr. Patrick Conway, CMS Deputy Administrator for Innovation and Quality and CMS Chief Medical Officer, on Monday, November 10, 2014 from 10:30am – 11:30 am ET. Dr. Conway will provided an update about the work of the CMS Innovation Center and the models being tested to improve better care for patients, better health for our communities, and lower costs through improvement for our health care system. Opportunities for questions were provided.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
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The Next Generation ACO Model team hosted an open door forum on Tuesday, February 28, 2017. During this open door forum Model team members provided a deep dive presentation examining details of financial aspects relating to the model.
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The Center for Medicare and Medicaid Innovation hosted a webinar on Thursday, October 8, 2015. The webinar provided an opportunity to learn more about efforts to solicit public comment on a variety of alternative payment pathways to increase value over volume.
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In follow-up to the March 10, 2015 announcement of the Next Generation Accountable Care Organization (ACO) Model of payment and care delivery, the Center for Medicare and Medicaid Innovation (CMS Innovation Center) hosted a repeat of the first open door forum in a series focusing on various aspects of the Model.
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The Primary Care First (PCF) Model Options team hosted a series of four informational webinars about the PCF Model Options. Topics discussed included the model options' aims, requirements, benefits of participation, and application next steps. Attendees had the opportunity to submit questions to the model options team during each of the webinars. Each of the webinars covered the same information.
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The Center for Medicare & Medicaid Innovation (CMS Innovation Center) hosted an open door forum providing letter of intent overview for the 2017 Next Generation Accountable Care Organization Model. The open door forum was held on Tuesday, March 22 from 4:00pm – 5:30pm EDT.
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CMS hosted an Open Door Forum call on November 22, 2013 to allow providers, suppliers, beneficiary advocacy groups, and other interested parties to provide input into the design and implementation of this demonstration. Mandated by the “Medicare IVIG Access and Strengthening Medicare and Repaying Taxpayers Act of 2012 (P.L. 112-242)”, the purpose of this demonstration is to evaluate the impact of providing payment for items and services needed for the in-home administration of IVIG for the treatment of primary immune deficiency disease (PIDD). The demonstration will provide these benefits for up to 4,000 Medicare beneficiaries for a period of three years.
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In this August 15, 2012 webinar CMS Innovation Center staff provided additional information for states that are interested in applying for a Model Testing award. Governors' offices were strongly encouraged to onvite their health care innovation team, key stakeholders and appropriate State officials such as State health department directors, Medicaid directors, and insurance commissioners.
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The CMS Innovation Center held the third in a series of webinars for potential applicants interested in applying to Health Care Innovation Awards Round Two. The webinar held on Tuesday, June 18, 2013 from 1:30–3:00pm EDT, focused on the remaining two of the four innovation categories.
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The CMS Innovation Center is hosting a conference call to discuss important updates regarding the Strong Start funding opportunity. Due to numerous questions and suggestions we have received from stakeholders, CMS is revising the Funding Opportunity Announcement (FOA) to respond to the important issues stakeholders have raised. CMS will extend the application deadline to allow potential applicants the time they need to develop innovative models.
More at: http://www.innovations.cms.gov/resources/StrongStart_ConferenceCall.html
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The CMS Innovation Center held the seventh in a series of webinars on Thursday, July 18, 2013 from 1:00–2:00pm EDT to provide an overview of the application package.
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The CMS Innovation Center held the eighth in a series of webinars about the Health Care Innovation Awards Round Two on Wednesday, July 24, 2013 from 1:00–2:00pm EDT to provide technical assistance on submitting an application.
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In this July 11, 2012 webinar, CMS Innovation Center staff discussed the amended Funding Opportunity Announcement (FOA) for the Strong Start for Mothers and Newborns initiative.
More at: http://www.innovations.cms.gov/resources/StrongStart_FOA.html
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The State Innovation Models initiative is a competitive funding opportunity for states to design and test multi-payer payment and service delivery models that deliver high-quality health care and improve health system performance.
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The Center for Medicare and Medicaid Innovation released a Request for Information (RFI) in late 2013 entitled the “Evolution of ACO Initiatives at CMS.” These are the second of two batches of responses received by the Center for Medicare and Medicaid Innovation to the RFI.
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CMS Innovation Center staff hosted a webinar for state officials on Tuesday, August 28, 2012 from 3:00pm to 4:00pm ET to provide additional information on the application process, financial templates and accessing Medicare data.
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The CMS Innovation Center held the fourth in a series of webinars for potential applicants interested in applying to Health Care Innovation Awards Round Two. The webinar held on Thursday, June 20, 2013 from 1:00–2:00pm EDT, focused on how to achieve lower costs through improvement. This webinar also reviewed the components of the Financial Plan.
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The Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents is an initiative designed to improve care for people living in nursing facilities who are enrolled in Medicare and Medicaid.
Through this initiative, CMS will partner with independent organizations to improve care for long-stay nursing facility residents. These organizations will collaborate with nursing facilities and States to provide coordinated, person-centered care with the goal of reducing avoidable hospital stays.
In this webinar, staff from the Medicare-Medicaid Coordination Office (MMCO) and the CMS Innovation Center will provide an overview of the initiative, and offer information about how to apply.
More at: http://innovations.cms.gov/resources/Duals_rahnfr_apply.html
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The CMS Innovation Center hosted a webinar on Wednesday, July 2, 2014, from 4:15pm-5:15pm EDT. The webinar reviewed Model Test Proposal Format Requirements, the ‘Population Health Plan’ Portion of the Model Test Project Narrative, and the Population Health Plan Deliverable of the Model Test Project Period.
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Strong Start is an initiative to reduce preterm births and early elective deliveries while improving outcomes for newborns and pregnant women.
Under this initiative, the Innovation Center will award up to $43 million through a competitive process to providers, States, managed care plans, and conveners to achieve better care, improved health, and lower costs for these women and their newborns.
CMS Innovation Center and Center for Medicaid and CHIP Services staff will be hosting a webinar that will discuss how applicants can prepare their budget for the Strong Start Medicaid funding opportunity.
More at: http://innovations.cms.gov/resources/StrongStart_McaidFundOpp.html
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CMS Innovation Center staff hosted this webinar for state officials to provide additional information on the application process, financial templates and accessing Medicare data.
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February 9, 2012
These slides are designed for Post-Acute Care (PAC) providers seeking additional information about how Model 3 works and a better understanding of the opportunities for PAC providers within the Bundled Payment for Care Improvement (BPCI) initiative to achieve better care, better health and lower costs for their patients through care redesign.
More at: http://innovations.cms.gov/resources/Bundled-Payments-Model-3-Deep-Dive.html
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This Accountable Health Communities Model webinar was held on Wednesday, February 10, 2016 from 3:00 – 4:00pm EST. The webinar focused on the anticipated role of state Medicaid agencies in the model.
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The CMS Innovation Center held the fifth in a series of webinars for potential applicants interested in applying to Health Care Innovation Awards Round Two. The webinar held on Wednesday, June 26, 2013 from 1:00–2:00pm EDT, focused on measuring project success and developing an operational plan.
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The Direct Contracting Model Options team hosted a webinar on January 22, 2020 to provide additional information on the Direct Contracting model's payment methodology following the Payment Part 1 Webinar on January 15th. The team presented on additional aspects of the financial model not covered during the Payment Part 1 Webinar, such as its risk adjustment, benchmark methodologies, and quality measures. The forum also provided an opportunity for potential applicants to ask the team questions regarding these topics and other topics related to the model application.
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This Medicare-Medicaid ACO Model webinar included information on the structure of the Model, Model details including beneficiary attribution, financial methodology and quality measurement options within the Model, and an explanation of data, learning and evaluation. The state-specific development and application process, including instructions for submitting letters of intent were also discussed. This webinar was open to the general public and targeted towards interested states.
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This webinar focuses on the new financial policies featured in the ACO REACH webinar. For more information on the financial methodology for the ACO REACH Model that will be transitioned from the Global and Professional Direct Contracting (GPDC) Model, please refer to prior released financial webinars available on the GPDC Model webpage.
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In follow-up to the March 10, 2015 announcement of the Next Generation Accountable Care Organization (ACO) Model of payment and care delivery, the Center for Medicare and Medicaid Innovation (CMS Innovation Center) hosted the first in a series of open door forums focusing on various aspects of the Model.
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Provides an overview of various ACO models existing in U.S. healthcare, their evolution and performance over last 5-6 years and provide a perspective on each of the model
On Thursday, September 24, 2015, the Medicare Advantage Value-Based Insurance Design Model team hosted a webinar. Attendees received an overview of the model as well an opportunity for questions and answers about the model.
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The CMS Innovation Center held a Medicare Advantage Value-Based Insurance Design Model webinar on August 24, 2016 from 2:00 – 3:00p.m. EDT. This webinar provided an overview of the changes to the model scheduled to take effect in 2018.
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The Center for Medicare & Medicaid Innovation (CMS Innovation Center) hosted an open door forum covering the application process for the 2017 Next Generation Accountable Care Organization Model on Tuesday, March 8, 2016 from 4:00 - 5:00pm EST.
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CECL - The Relationship Between Credit and FinanceLibby Bierman
CECL planning requires collaboration between a bank or credit union's credit and finance functions for the aggregation and analysis of credit loss history. In these slides, find out how decisions made early in your implementation process will influence your ability to leverage results/outputs.
The allocation of executive compensation resources is being scrutinized by internal and external forces. Regulations, board governance issues, and the lower margins require new thought processes on the various pieces of the compensation puzzle and how they fit together.
The CMS Innovation Center hosted a Beneficiary Engagement and Incentives: Shared Decision Making (SDM) Model webinar regarding the model overview and Letter of Intent (LOI) process on Tuesday, January 10, 2017 from 2:00 - 3:00 p.m. EST. At this event, attendees learned more about the SDM model, eligibility criteria, and LOI requirements.
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The Evolution of Benefits and Payroll Integration: Advancing Your OptionsCBIZ, Inc.
Jim O'Connor and Wendra Johnson take part in our Business and Insurance Webinar Series 2016 where they discuss the evolution of benefits and payroll integration.
The Medicare Advantage Value-Based Insurance Design (VBID) Model team at the Center for Medicare and Medicaid Innovation (CMMI) and national leaders participated in a discussion around pathways for addressing food and nutritional insecurity at webinar event of our Health Equity Incubation Program on Thursday, March 31, 2022, from 3:00-4:30 PM ET.
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The CMS Innovation Center hosted an office hours session on Tuesday, April 5, 2022 from 3:00-4:00 PM ET to discuss the Medicare Advantage Value-Based Insurance Design (VBID) Model and its Hospice Benefit Component. Attendees received an overview of the Model and the CY 2023 application process, and had an opportunity for questions and answers with the Model team.
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The ACO REACH Model Team will hosted a health equity webinar on Tuesday, April 5, 2022 from 4:00 - 5:00 p.m. EDT. The ACO REACH Model team highlighted Health Equity provisions added to the ACO REACH Model.
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During this webinar, a high-level overview of the ACO REACH Model was provided including information on the participation and eligibility requirements, Accountable Care Organization (ACO) types, payment mechanisms, and beneficiary alignment methodology.
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The CMS Innovation Center will host a webinar on Thursday, March 10, 2022 from 3:00-4:00 PM ET. During this webinar, presenters will provide a brief review of the recently released Calendar Year (CY) 2023 Requests for Applications (RFAs) for the VBID Model and the Hospice Benefit Component as well as the payment design related to the Hospice Benefit Component of the VBID Model. This session will also offer attendees an opportunity to ask follow-up questions.
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This webinar provided an overview of the Model and the Part D Sponsor application process, as well as included a Q&A session for interested Part D sponsors.
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The CMS Innovation Center hosted a webinar on Wednesday, March 2, 2022 at 3pm – 4pm ET, during which presenters shared updates on the Comprehensive End Stage Renal Disease (ESRD) Care (CEC) Model, the Kidney Care Choices (KCC) Model, and the End-Stage Renal Disease (ESRD) Treatment Choices (ETC) Model. This event was available to the first 1,000 registrants. Presentation materials will be available on the respective model webpages following the session.
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The Medicare Advantage Value-Based Insurance Design (VBID) Model Team hosted an office hours session on Thursday February 3rd, 2022 on the Hospice Benefit Component to provide technical and operational support to interested stakeholders. During this office hours session, presenters answered questions submitted in advance to the VBID Mailbox and offered attendees an opportunity to ask additional questions.
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Has your organization prioritized addressing health inequities? How can a Center for Medicare and Medicaid Innovation (CMMI) Model factor into your organization’s health equity strategy? How can you structure your plan’s benefits to have the greatest impact on underserved communities? What partnership opportunities are available with CMMI?
These are important questions CMMI plans to answer in a new webinar series focused on health equity! CMMI is sponsoring a series of webinars for current and potential Medicare Advantage Organization (MAO) participants in the Value-Based Insurance Design (VBID) Model.
The first webinar in the series provided an overview of the Model’s Health Equity Incubation Sessions effort, articulated a business case for MAOs to leverage VBID Model Components to address health inequities in their member populations, and provided specific guidance and clarification on the full extent of health equity focused flexibilities that fall under the Model’s waiver authority.
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CMMI, in partnership with Million Hearts® at the Centers for Disease Control and Prevention (CDC), will sponsor a webinar entitled Value-Based Insurance Design, Opportunities to Improve Medication Adherence for Cardiovascular Disease Prevention on October 21, 2021 from 3:00-4:00 PM ET. The webinar will present evidence-based high impact strategies for MAOs to improve care and outcomes for beneficiaries with cardiovascular disease (CVD), including underserved populations.
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As part of a broader partnership, CMMI, the Office of the Assistant Secretary for Health (OASH) and the Administration for Community Living (ACL) are jointly sponsoring a webinar titled, Unleashing the Capabilities of MAOs to Deliver Health Innovation for Older Adults in Underserved Settings on October 7 from 2:30-4:00 PM ET to highlight the emerging, numerous opportunities for MAOs to support beneficiaries in more fully meeting their care needs and goals through novel approaches and services enabled by technology.
The webinar will provide an overview of the data supporting these opportunities and will include a panel of three speakers from payer organizations, each of whom will provide an overview of their experience and results in innovating in the use of technology to address unmet enrollee health needs. Panelists include Mona Siddiqui MD, MPH, Senior Vice President for Enterprise Clinical Strategy and Quality at Humana, who will discuss Humana’s approach to the use of data and predictive modeling to proactively engage and provide care for the highest risk and most vulnerable populations; John Wiecha, Medical Director, Senior Products Division at Point32Health, representing the newly combined organizations of Harvard Pilgrim Health Care and Tufts Health Plan will provide an overview of a recent pilot project to improve dementia care through a digital caregiver support program; and Caesar A. DeLeo, MD, MHSA Vice President & Executive Medical Director Strategic Initiatives, Highmark Health Enterprise Clinical Organization, Highmark BCBS who will discuss Highmark’s experience with telemedicine to approach substance use disorders during the pandemic and results from a five-year data driven program addressing appropriate opiate prescribing through profiling and academic detailing.
The webinar offers attendees the opportunity to gain a better understanding of the evidence and potential of several technology-enabled services in improving access, quality and outcomes of care, including, importantly, for underserved populations and will provide MAOs with insights more broadly on the challenges and solutions in design, implementation and evaluation of innovative and technology-enabled service. MAOs that are considering such innovations who may wish to target the use of technology-enabled and/or other services based on chronic illness and/or Low-Income Subsidy (LIS) status through the VBID Model are encouraged to attend.
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The ET3 Model and Medicaid: Opportunities for Alignment webinar provided background on the ET3 Model, discussed the benefits for states of aligning coverage and payment policies with ET3, and explored considerations for states seeking to implement new Medicaid services that align with the ET3 Model. This webinar was intended for state Medicaid agencies, ET3 Model Participants, and other stakeholders interested in learning more about optional Medicaid alignment with the ET3 Model.
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CMS announced an Office Hour event for potential applicants to ask questions ahead of the PCF application deadline.
The PCF Model Team was available to answer questions on key topics including eligibility, payment design and attribution, and more.
You may also refer to the materials from the two PCF webinars held in March: Introduction to PCF and Ready, Set, Apply.
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In order to help ETC Model Participants prepare for the ETC Model, CMS conducted an introductory webinar on Wednesday, December 9, 2020 from 1 p.m. to 2 p.m. The webinar provided an overview of the ETC Model, including:
Participant selection
The Home Dialysis Payment Adjustment
The Performance Payment Adjustment
The ETC Model timeline, including the timing of payment adjustments
Information about how to communicate with CMS about the ETC Model
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The Value-Based Insurance Design (VBID) Model team hosted a webinar on January 28, 2021 from 4:00-5:00 PM EST. During this webinar, presenters provided a brief review of the recently released Calendar Year (CY) 2022 Requests for Applications (RFAs) for the VBID Model and the Hospice Benefit Component. This session also offered attendees an opportunity to ask follow-up questions.
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The Medicare Advantage Value-Based Insurance Design (VBID) Model team hosted a webinar on Wednesday, March 17, 2021 from 4:00 - 5:00 PM EDT. During this webinar, presenters provided a preview of the Calendar Year 2022 payment design related to the Hospice Benefit Component of the VBID Model. The session also offered attendees an opportunity to ask follow-up questions.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
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http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
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CMS Innovation Center
http://innovation.cms.gov
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CMS Innovation Center
http://innovation.cms.gov
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http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
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http://innovation.cms.gov
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The Primary Care First Model Options team provided an overview of the Model, including goals, eligibility to participate in the second cohort, payment design and attribution, and data sharing. Model staff answered your questions about these topics.
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http://innovation.cms.gov
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Webinar: Comprehensive End-Stage Renal Disease Care (CEC) Model – Finance and Quality Methodologies
1. Comprehensive ESRD Care (CEC) Model
Welcome to Today’s Webinar
Overview of the CEC Alignment, Finance,
and Quality Methodologies
We will begin promptly at 4 PM EST
Dial-in: 1-800-832-0736
Meeting Room: *6291628#
Note: All attendee phone lines
are muted to prevent audio feedback.
June 29, 2016 4-5 PM EST
2. Overview of the CEC Alignment, Finance,
and Quality Methodologies
Center for Medicare &
Medicaid Innovation (CMMI)
Centers for Medicare &
Medicaid Services (CMS)
U.S. Department of Health
and Human Services (HHS)
June 29, 2016
3. Disclaimer
The comments made on this call are offered only for general informational
and educational purposes. As always, the agency’s positions on matters may
be subject to change. CMS’s comments are not offered as, and do not
constitute legal advice or legal opinions, and no statement made on this call
will preclude the agency and/or its law enforcement partners from enforcing
any and all applicable laws, rules and regulations. ACOs are responsible for
ensuring that their actions fully comply with applicable laws, rules and
regulations, and we encourage you to consult with your own legal counsel to
ensure such compliance.
Furthermore, to the extent that we may seek to gather facts and information
from you during this call, we intend to gather your individual input. CMS is
not seeking group advice.
4. Tips for a Successful Event
Click here to
download a PDF copy
of the slides along
with the CEC RFA Fact
Sheet
Type questions here
and hit “Enter”
Telephone
– All attendee phone lines are muted
– This session will be recorded for posting online
Webinar Environment Features
– Please submit any questions you have in the
Q & A box – Questions in the chat box will be answered in the order they
are entered at the end of the presentation. If your question is unable to
be addressed during this time,
please email your questions following this webinar to ESRD-
CMMI@cms.hhs.gov
– Download the slides in the box in the
lower right corner of your screen
– A short survey will be available at the
end of the presentation
5. Agenda for Today’s Discussion
• Overview of CEC Alignment Methodology
–Q&A
• Overview of CEC Financial Methodology
–Q&A
• Overview of CEC Quality Methodology
–Q&A
1
6. 1
Emma Oppenheim, MSPH
Social Science Research Analyst
Thomasina Anane, MBA
Health Insurance Specialist
Kate Blackwell, MPH
Social Science Research Analyst
Sid Mazumdar, PhD
Social Science Research Analyst
Our Experts from the Innovation Center
8. What is Beneficiary Alignment?
Beneficiary alignment includes:
• Identifying beneficiaries eligible for the CEC Model
• Aligning eligible beneficiaries to ESCOs
• Identifying reference group beneficiaries
• Transmitting beneficiary alignment information to
ESCOs
8
9. Eligibility Criteria
• Central role of dialysis providers
– Align to an ESCO based on 72x claims
• Accountability for aligned beneficiaries and patient centeredness
– “First touch” prospective alignment
– One visit to an ESCO dialysis facility means a beneficiary is aligned for the rest of the year
• Eligibility criteria
– Beneficiary must be enrolled in Medicare FFS (both Parts A and B)
– Medicare must be primary payer
– No Medicare Advantage
– No transplant in the previous twelve months
– Over 18
– Residence in the United States
– Not enrolled in another CMS shared savings program
9
10. 10
• The alignment algorithm is designed to be as accurate as possible, by only
holding ESCOs accountable for beneficiaries who visit their dialysis clinics
• Alignment through the dialysis facility does not necessarily align with
nephrology practice
– Try to bring in nephrologists who see the patients at your clinics
• Alignment criteria means that a significant fraction of beneficiaries in your
clinics will not be aligned to your ESCO
– Especially significant for beneficiaries transitioning onto Medicare during
first 90 days
• Alignment list grows during the year
– At the end of the year, CMS removes beneficiaries who have moved, died,
undergone transplant, or who have not visited an ESCO clinic
– Only the final list is used for financial reconciliation
Key Points on Alignment
11. Question and Answer Session
• We will now pause to address questions from the audience to
our experts from the Innovation Center CEC Model Team .
• To submit a question, please type it into the “Q & A” entry
window.
• Questions will be answered on a “first come, first served”
basis.
Type questions
here and hit
“Enter”
11
13. Goals of the Financial Methodology
• Calculate aligned beneficiaries’ actual expenditures during a
given performance year
• Calculate benchmark using expenditures of beneficiaries
aligned to the ESCO in historical period and trending
forward to performance year
• Calculate shared savings or shared losses
1
13
2
3
14. • Large Dialysis Organizations (200 or more dialysis facilities, following USRDS definition )
– Two-sided risk
– Financial guarantee required
– May select a variable MSR/MLR of between 1-2% (inclusive) at the start of each performance year
• Non-Large Dialysis Organizations (fewer than 200 dialysis facilities, following USRDS definition ) – Two-
Sided Track
– Two-sided risk
– Financial guarantee required
– Performance is aggregated with other two-sided Non-LDOs if beneficiary alignment numbers are too
low or if ESCO elects to have its beneficiaries grouped in an Aggregation Pool
– May select a variable MSR/MLR of up to 1-2% at the start of each performance year
• Non-Large Dialysis Organizations (fewer than 200 dialysis facilities, following USRDS definition ) – One-
Sided Track
– One-sided risk
– No downside, so financial guarantee is not required
– Performance is aggregated with other one-sided Non-LDOs if beneficiary alignment numbers are too
low or if ESCO elects to have its beneficiaries grouped in an Aggregation Pool
– Minimum savings rate is based off of the number of beneficiaries in the ESCO or aggregation pool
Three Risk Tracks
14
15. 15
• ESRD Seamless Care Organizations (ESCOs) are accountable
for their aligned beneficiaries’ Medicare Parts A and B care,
regardless of where that care is delivered
–Does not include Part D costs or costs from other payers
including Medicaid
• Shared savings if aligned beneficiaries’ expenditures are
below benchmark outside the MSR (minimum savings rate)
• If in two-sided risk, shared losses if beneficiaries’
expenditures are above benchmark outside the MLR
(minimum loss rate)
ESCO Financial Responsibility
16. Overview of Financial Methodology
1A
Identify
Eligible
Beneficiaries
2A
Align Eligible
Beneficiaries
to ESCO
3
Base Year (BY)
Expenditures
5
Performance
Year Expenditure
Benchmarks
6
Performance Year
(PY) Expenditures
7
Compare
8
Shared
Savings/Loss
1B
Identify
Eligible
Beneficiaries
2B
Align Eligible
Beneficiaries
to ESCO
Calculations using performance year data
4
Historical
Expenditure
Baseline
Calculations using base year data
16
17. Key Features of CEC Financial Methodology
• Historical Expenditure Baseline
• Performance Year (PY) Expenditure Benchmark
• Comparing PY Expenditures to PY Benchmark
• Determining ESCO Shared Savings/Losses
– LDO
• Discount
– Non LDO
• Aggregation
17
18. Historical Expenditure Baseline
Adjustments to BY1 and BY2
Per Bene Per Year (PBPY)
Expenditures
Trending: Multiply BY1 and BY2 PBPY
by the growth rate in the national
ESRD population’s per capita
expenditures
Risk adjustment: Multiply BY1 and
BY2 PBPY by the growth rate in the
aligned population’s HCC or
demographic risk scores
BY1 (2012)
Claims
BY2 (2013)
Claims
Trending
Risk
Adjustment
BY1 Adj PBPY BY2 Adj PBPY BY3 PBPY
Historical Expenditure Baseline
BY3 (2014)
Claims
BY1 PBPY BY2 PBPY
Calculations are performed separately for five eligibility
categories:
- Aged dual - Disabled non-dual
- Aged non-dual - ESRD only
- Disabled dual
18
19. Key Features of CEC Financial Methodology
• Historical Expenditure Baseline
• Performance Year (PY) Expenditure Benchmark
• Comparing PY Expenditures to PY Benchmark
• Determining ESCO Shared Savings/Losses
– LDO
• Discount
– Non LDO
• Aggregation
19
20. Performance Year Expenditure Benchmarks
This produces eligibility category PY benchmark expenditures.
Calculate total PY expenditure benchmarks by aggregating across eligibility categories,
accounting for differing beneficiary-years in each of them
Final Benchmark will not be known until the end of the year when the correct risk
adjustment and trending factors can be applied
20
21. 21
• Historical Expenditure Baseline
• Performance Year (PY) Expenditure Benchmark
• Comparing PY Expenditures to PY Benchmark
• Determining ESCO Shared Savings/Losses
– LDO
• Discount
– Non LDO
• Aggregation
Key Features of CEC Financial Methodology
22. 22
Gross Savings/Losses =
total expenditure benchmark
– total PY expenditures
• If result is > 0, the ESCO is eligible for shared savings
• If result is < 0, the ESCO is eligible for shared losses
• Shared Savings/Losses:
– Must satisfy Minimum Savings Rate (MSR)/Minimum Loss Rate (MLR)
– Savings/Loss multiplier accounts for quality performance and adjusts accordingly
– Savings/Loss cap applied
Comparing PY Expenditures to PY Benchmark:
Determining ESCO Shared Savings/Losses
23. CEC’s Financial Methodology Differs for
LDOs vs. Non LDOs
LDOs
Non LDOs
(2-Sided Risk)
Non LDOs
(1-Sided Risk)
MSR/MLR
+/-1% threshold for first-dollar
shared savings or losses
(option for higher threshold of
up to +/- 2% if desired)
+/-1% threshold for first-dollar
shared savings or losses
(option for higher threshold of
up to +/-
2% if desired)
4.75% MSR for first-dollar
shared savings at 350
beneficiaries, decreasing to 4%
at 500 beneficiaries,
decreasing to 2% as number of
beneficiaries increase to 2,000
Discount
Applied
(PY2 – 1%, PY3 – 2%, PY4+ -
3%)
Not applied Not applied
Shared Savings /
Shared Loss
Percentages
After locking in guaranteed
discounts, 75%
50% 75%
Shared Savings/Loss Cap
Shared Savings/Loss Cap 10%
to 15% depending on the PY
Shared Savings/Loss Cap 10%
to 15% depending on the PY Shared Savings Cap is 5% for all
PYs
Rebasing No rebasing No rebasing No rebasing
23
24. • For Non-LDOs only: Process of combining financial performance to likely increase
reliability of financial results and possibly reduce the Minimum Savings Rate:
– for non-LDOs who may not meet the 350 beneficiary threshold (required)
– for non-LDOs that voluntarily opt to aggregate (optional)
• Aggregated benchmark and aggregated PY expenditure figures are based on PBPY
expenditures for all ESCOs that have their beneficiaries grouped in a particular
aggregation pool
• CMS will determine makeup of aggregation pools based on number of non-LDOs
in each risk track
– ESCOs may share preferences with CMS, but the makeup of the pools will be at
CMS discretion
Aggregation
24
25. Types of Performance Year Financial Reports
• Baseline Report
• Monthly Expenditure and Claims Lag Reports
• Claims and Claim Line Feed (CCLF)
• Quarterly Expenditure Reports
• Reconciliation Report
25
26. 26
• Mid-year reports annualize partial years of expenditures
• Mid-year reports use trending based on a partial year of
alignment eligible (i.e., reference) population expenditures
• Alignment reconciliation and exclusions occurs at the end of
the year
• Only the final expenditure report at the end of the year will
provide a comprehensive view of all relevant adjustments,
including expenditure capping
General Caveats for Expenditure Reports
27. 27
• CMS strives for accuracy over prospectivity in the CEC model
– Interim finance reports are meant to provide a general idea of ESCO performance
– Final expenditure figures and adjustments will occur at the end of the PY
– Final benchmark will not be known at the end of the year
• Alignment and Finance are inherently linked
– Won’t know final costs or benchmark until after alignment reconciliation is performed
– Any change in makeup of beneficiaries in baseline years or performance years will change
savings/losses
• CMS values partnership and transparency
– We understand the risk that you are taking
– The CEC Finance Team seeks to provide clear communication and the tools necessary for
understanding financial figures and the utility of the reports
Key Takeaways
28. Question and Answer Session
• We will now pause to address questions from the audience to
our experts from the Innovation Center CEC Model Team .
• To submit a question, please type it into the “Q & A” entry
window.
• Questions will be answered on a “first come, first served”
basis.
Type questions
here and hit
“Enter”
28
30. 30
• Encourages ESCOs to meet clinical care standards, provide patient-centered care and coordinate care
across settings
• Incentivizes quality performance against national benchmarks and year-to-year improvement whereby
ESCOs receive the higher of the two scores.
• Create a financial incentive to perform well on quality by using the quality score to adjust savings/losses
• Phase-in pay for performance
– PY2 FOR NEW ESCOS ONLY: Pay for reporting for all measures
– PY2 and beyond: Pay for performance for all measures
• Utilizes a set of process, clinical outcome and patient experience/quality of life quality measures that
align with the priorities of the National Quality Strategy (NQS)
– Patient Safety (4 measures)
– Person- and Caregiver-Centered Experience and Outcomes (2 measures)
– Communication and Care Coordination (2 measures)
– Clinical Quality of Care (8 measures)
– Population HealthCare (3 measures)
CEC Quality Strategy
31. 31
• Multi-Step selection process
– List of candidate measures
– CEC Measure Evaluation Technical Expert Panel
– Public comment
– Measure feasibility research
– Input from:
o CMS Quality Measures Task Force
o Medicare-Medicaid Coordination Office
o NQF-organized MAP Dual Eligible Beneficiaries Workgroup
CMS determined final CEC Quality Measure Set
• Opportunities for updates based upon ESCO feedback and CMS priorities in
advance of each PY
CEC Quality Measure Selection
32. CEC Quality Measures
Measure Title NQF #
Measure
Steward
Domain
Diabetes Care: Eye Exam 0055 NCQA Clinical Quality of Care
Diabetes Care: Foot Exam 0056 NCQA Clinical Quality of Care
Advance Care Plan Adapted from 0326 NCQA
Person- and Caregiver-Centered
Experience and Outcomes
Medication Reconciliation Post-Discharge 0554 NCQA Communication and Care Coordination
Influenza Immunization for the ESRD Population Adapted from 0226 KCQA Population Health
Pneumococcal Vaccination Status Adapted from 0043 NCQA Population Health
Screening for Clinical Depression and Follow-Up Plan Adapted from 0418 CMS Population Health
Tobacco Use: Screening and Cessation Intervention Adapted from 0028 AMA PCPI Population Health
Falls: Screening, Risk Assessment and Plan of Care to
Prevent Future Falls
Adapted from 0101 NCQA Patient Safety
• Data Source: Hybrid – Claims and Medical Records
• Measures that read “Adapted from …” in the “NQF #” column are those with changes from existing specifications such as expanded
age ranges (e.g., 18 and older instead of 65 and older) or alternate data sources from the NQF-endorsed measure
• Measures with an age stratification (e.g., 18 and older instead of all ages) are not considered adaptations from the NQF-endorsed
measures
32
33. CEC Quality Measures (Continued)
Measure Title NQF #
Measure
Steward
Domain
Kidney Disease Quality of Life (KDQOL) Survey N/A RAND
Person- and Caregiver-Centered
Experience and Outcomes
ICH CAHPS: Nephrologists’ Communication and
Caring
0258 AHRQ
Person- and Caregiver-Centered
Experience and Outcomes
ICH CAHPS: Quality of Dialysis Center Care and
Operations
0258 AHRQ
Person- and Caregiver-Centered
Experience and Outcomes
ICH CAHPS: Providing Information to Patients 0258 AHRQ
Person- and Caregiver-Centered
Experience and Outcomes
ICH CAHPS: Rating of Kidney Doctors 0258 AHRQ
Person- and Caregiver-Centered
Experience and Outcomes
ICH CAHPS: Rating of Dialysis Center Staff 0258 AHRQ
Person- and Caregiver-Centered
Experience and Outcomes
ICH CAHPS: Rating of Dialysis Center 0258 AHRQ
Person- and Caregiver-Centered
Experience and Outcomes
• Data Source: Survey
33
34. CEC Quality Measures (Continued)
Measure Title NQF #
Measure
Steward
Domain
Bloodstream Infection in Hemodialysis Outpatients 1460 CDC Patient Safety
Hemodialysis Adequacy: Minimum Delivered
Hemodialysis Dose
0249 CMS Clinical Quality of Care
Proportion of Patients with Hypercalcemia 1454 CMS Clinical Quality of Care
Peritoneal Dialysis Adequacy: Delivered Dose of
Peritoneal Dialysis Above Minimum
0318 CMS Clinical Quality of Care
Hemodialysis Vascular Access: Maximizing Placement
of Arterial Venous Fistula
0257 CMS Clinical Quality of Care
Hemodialysis Vascular Access: Minimizing Use of
Catheters as Chronic Dialysis Access
0256 CMS Clinical Quality of Care
Standardized Mortality Ratio 0369 CMS Patient Safety
Standardized Hospitalization Ratio for Admissions 1463 CMS
Communication and Care
Coordination
Standardized Readmission Ratio 2496 CMS
Communication and Care
Coordination
• Data Source: Dialysis Facility Measure Results
• The ESRD QIP generates measures results from Medicare claims, the Consolidated Renal Operations in a Web-Enabled Network
(CROWNWeb), and the National Healthcare Safety Network (NHSN)
34
35. CEC Quality Performance Score
Performance Scale Quality Points Earned Improvement Scale
90+ percentile national performance 2.0 Not applicable
75+ percentile national performance 1.5 Greater than 10%
50+ percentile national performance 1.0 Greater than 5% up to 10%
30-49 percentile national performance 0.5 Up to 5%
<30 percentile national performance No points Less than or equal to previous
year’s rate
• Performance Year 2: New ESCOs will receive 2 points for each measure completely and accurately reported
− ESCO meets all reporting requirements including timing and reporting requested data for all measures
• Performance Year 3: All ESCOs will earn points on a sliding scale, based on either
• Performance compared to national benchmark
• Improvement from previous year’s results
• ESCOs earn the higher of two scores
• ESCOs must maintain the minimum QIP TPS threshold to qualify for shared savings
35
36. 36
• CEC Total Quality Score (TQS) will be derived by adding the individual measure
scores for all required measures
− Each measure’s score will be derived by determining the quality and
improvement points, and multiplying the higher of the two by the measure
weight. The sum of the individual measure scores will be used to calculate the
ESCO TQS
− ESCOs that do not meet the minimum level for a given measure will get zero
points for that particular measure. Under improvement scoring, ESCOs receive
points for the percentage improvement from the previous year’s results
• CEC Operations Contractor will develop annual TQS reports for each ESCO
• Total quality score will then be used to adjust shared savings or losses
CEC Total Quality Score
37. 37
• 36-item questionnaire developed by the RAND Corporation to measure
− Physical and mental well-being
− Burden of kidney disease
− Treatment-associated symptoms and problems
− Effect of kidney disease on daily life
• 7 questions about dialysis modality and personal situation
• CMS is currently considering options for analyzing and scoring the KDQOL survey
measure beginning in 2018
• CMS has administered the survey to ESCO-aligned beneficiaries in 2016
• A survey to the full census of aligned beneficiaries is planned for early 2017
• A final approach will be determined after reviewing 2016 and 2017 data
Kidney Disease Quality of Life (KDQoL) Survey
38. Question and Answer Session
• We will now pause to address questions from the audience to
our experts from the Innovation Center CEC Model Team .
• To submit a question, please type it into the “Q & A” entry
window.
• Questions will be answered on a “first come, first served”
basis.
Type questions
here and hit
“Enter”
38
39. Upcoming Learning Events
• Webinar: Clinical Providers and the CEC Model
– July 7 (6 – 7 pm ET)
• Office Hours: Application Questions & Support
– July 6 (1 – 2 pm ET)
– July 12 (3 – 4 pm ET)
– July 14 (12 – 1 pm ET)
* Registration links for the above webinars, as well as the link to connect to office hours during the above
times will be emailed to the email address you used to register for this webinar.
39
40. Thank You for Participating in
Today’s Learning Event!
• The recording, transcript and slides from today’s event will be available on the
CMMI website: https://innovation.cms.gov/initiatives/comprehensive-esrd-care/
• Also visit the CEC model website to access model-specific details, including,
recordings and slides from previous learning events, a copy of the updated RFA and
the new RFA fact sheet
We appreciate your feedback on this webinar! Please complete a brief survey by
either clicking this link: https://www.surveymonkey.com/r/CECJun29
Or, use the Survey Pod that is on your screen:
Click the Post
Event Survey
Then click
“Browse To”
40
41. CEC Team Contact Information
Tom Duvall, MBA
Operations Analyst
Emma Oppenheim, MSPH
Social Science Research Analyst
Magda Barini-Garcia, CAPT, MD, MPH
Improvement Advisor/Medical Officer
For future questions pertaining to today’s event or regarding the CEC model,
please email: ESRD-CMMI@cms.hhs.gov. Thank you!
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