NAACO DRAFT COMMENTS ON THE MA DATA COLLECTION AND TRANSPARENCY RFI
NAACOS is submitting comments in response to request for information (RFI) on Medicare Advantage (MA) data and transparency. Our comments reflect the need for providers and stakeholders to have access to comprehensive MA data sets to promote program and payment transparency. Please review the draft comment letter and send any feedback to Diwen Chen by Friday, May 24.
NAACOS PARTICIPATES IN ROUNDTABLE WITH SENATE MACRA WORKING GROUP
On May 14, NAACOS’ government affairs team met with the Senate’s bipartisan Medicare Payment Reform Working Group. During the roundtable meeting NAACOS and other stakeholders focused on the need to extend Medicare’s advanced alternative payment model (APM) incentives before the end of the year, along with outlining longer-term solutions to continue driving the transition to value.
PATIENT STORIES FROM THE ALLIANCE FOR VALUE-BASED PATIENT CARE
Check out patient stories collected through the work of the Alliance for Value-Based Patient Care. These stories demonstrate the power of value-based care and reasons why policymakers should support this work. We will continue highlighting patient stories. Submit any stories from your organization or contact David Pittman for more information.
Follow the Alliance on LinkedIn and Twitter.
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Envoy Integrated Health ACO
Anchorage, AK |
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SENATE FINANCE COMMITTEE RELEASES WHITE PAPER ON PHYSICIAN PAYMENT
On May 17, Senate Finance Committee Chairman Ron Wyden (D-OR) and Ranking Member Mike Crapo (R-ID) released a bipartisan white paper outlining the committee’s priorities for reforming Medicare’s physician payment system, which include:
- Creating sustainable payment updates to ensure clinicians can own and operate their practices;
- Incentivizing alternative payment models that reward providing better care at a lower cost;
- Rethinking how Medicare measures quality care;
- Improving primary care;
- Supporting chronic care benefits in Medicare fee-for-service; and
- Ensuring continued access to telehealth.
Reforming the Medicare payment system to promote value-based care remains one of NAACOS’ top legislative priorities. A NAACOS statement applauding the committee for their work is available.
SENATORS INTRODUCE LEGISLATION TO ESTABLISH HYBRID-PRIMARY CARE PAYMENTS
Senators Sheldon Whitehouse (D-RI) and Bill Cassidy (R-LA) introduced legislation to reform Medicare’s primary care payment system. The Pay PCPs Act (S. 4338) encourages CMS to establish hybrid payments for primary care providers (PCPs), reduces cost-sharing, and establishes a new technical advisory committee to help CMS more accurately determine Fee Schedule rates.
NAACOS supports prospective population-based payments for primary care and will be submitting comments to the senators encouraging them to ensure that these reforms are focused on expanding value models. Please share any input on the request for information with Alyssa Neumann by June 8.
CONGRESSIONAL COMMITTEES CONTINUE TO HOLD HEALTH HEARINGS
Telehealth and Hospital at Home – The House Ways and Means and Energy and Commerce Committees both approved temporary extensions of these programs that are scheduled to expire at the end of 2024.
Rural Health – The Senate Finance Committee held a hearing exploring ways to improve health care access and outcomes in rural communities, which included a robust discussion about extending telehealth and hospital at home programs.
Consolidation – The House Budget Committee held a hearing examining the budgetary effects of health care consolidation. The House Ways and Means Committee held a hearing examining the challenges facing independent medical practices.
CATHETER CODE ADDED TO CMS ‘WATCH LIST’
CMS has added catheter code (A4353) to the list of codes that could be subject to prior authorization or other program integrity safeguards in the future. More background on the conditions of payment CMS sets for certain durable medical equipment is available. Meanwhile, NAACOS continues to advocate that CMS remove this anomalous billing from ACO expenditures, trend updates, and benchmarks.
CMS PROPOSES MANDATORY KIDNEY TRANSPLANT MODEL
CMS has proposed a mandatory payment model to start in January 2025. The six-year Increasing Organ Transplant Access (IOTA) Model would assess hospitals on organ acceptance rate, survival rate, and other domains, including a health equity component. Eligible hospitals are those that conduct at least 11 transplants during a three-year baseline period. CMS estimates 90 of the more than 250 transplant hospitals in the country would be required to participate. The model would incorporate downside risk in 2026. Comments on the proposed model are due July 16. HHS’s fact sheet and press release are also available online.
CMS RELEASES QUALITY PAYMENT PROGRAM REPORT
Advanced APMs – The most recent report from CMS shows a 26 percent increase in the percentage of clinicians participating in Advanced APMs. It also shows that 386,263 clinicians qualified as Qualifying APM Participants (QPs) in 2022, which is a 41 percent increase from 2021.
MIPS – According to an analysis of the PUF data, the 2022 Merit Based Incentive Payment System (MIPS) performance data shows APMs and MSSP outperformed traditional MIPS clinicians.
- The mean quality score for MSSP is 82, APMs 81, groups 63, individuals 33.
Find the report and summary here:
NEW PI AND QUALITY RESOURCES
Check out two new resources NAACOS has developed to assist ACOs in understanding Promoting Interoperability (PI) and quality requirements. The first is a quality resource that explains how to access quality measure benchmarks and when to expect updates. The second is a resource outlining Promoting Interoperability requirements that are going into effect in 2025. If you have any questions, email [email protected].
ACO SHOWDOWN SUBMISSION DEADLINE EXTENDED TO MAY 31
Does your organization have an original cardiac care innovation such as unique workflows that include e-consults, treatment protocols or pre-referral testing pathways? If so, you can enter the NAACOS ACO Showdown focused on cardiac care to win some great prizes. Our first ACO Showdown is sponsored by iRhythm, offering the Zio patch, and Heartbeat Health, tech-enabled cardiology care. In this competition, you will have approximately 15 minutes to do a “Shark Tank” style presentation on your innovation. A live audience will vote to find the winning order of our competitors.
Prizes are as follows:
- 1st prize – 1 NAACOS conference/boot camp paid registration and $500 gift card for Grubhub, DoorDash, or Uber Eats for the winning organization’s team to celebrate with a meal or food of their choosing.
- 2nd prize – $300 gift card for Grubhub, DoorDash, or Uber Eats
- 3rd prize – $200 gift card for Grubhub, DoorDash, or Uber Eats
Don’t wait – register today to showcase your cardiac innovations and get some delicious rewards!
IS YOUR ACO APPLYING OR RENEWING ITS MSSP CONTRACT?
NAACOS is holding the MSSP 2025 Application Insights webinar on May 29 from 2:00 to 3:00 pm ET. This webinar will provide information on policy updates related to the MSSP application presented by Alyssa Neumann, NAACOS senior analyst, regulatory affairs, along with tips and tricks for preparing and submitting the MSSP application presented by David Ault, counsel, Ropes and Gray LLP. Travis Broome, SVP of policy and economics, Aledade, will provide additional insights into the upcoming ACO Primary Care Flex (PC Flex) and considerations for early renewal. Register today to join this event.
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