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HELP NAACOS ELEVATE OUR VOICE ON KEY TOPICS
NAACOS continually demonstrates how ACOs can help address some of the key challenges in health care. We need your stories and examples to help elevate our role. Please reach out to
[email protected] if you have implemented strategies in these areas that are currently a focus for Congress
and the administration:
- Drug Pricing, specifically addressing the Part B spending costs in your ACO
- Behavioral Health
- Workforce, specifically how participation in ACOs have helped you reshape care teams to reduce clinician burden
NAACOS SUBMITS COMMENTS TO SENATE FINANCE COMMITTEE
The Senate Finance Committee recently
held a hearing to
discuss consolidation and corporate ownership in health care. While the hearing touched on a wide range of topics, there was a robust discussion about the need to move Medicare’s payment
system towards value. NAACOS
submitted a statement for the hearing record.
JOIN US FOR THE NEXT ACO REACH LEARNING DISCUSSION
NAACOS’ next ACO REACH Learning Discussion will take place June 16, 12:00–1:00 pm ET. This month, the topic is building networks through preferred providers. Participation is limited to those
participating in ACO REACH, and advanced registration is required. If
you have questions or additional topics you want discussed, please share them in advance by emailing
[email protected].
JOIN OUR FQHC, RURAL HEALTH WORKING GROUP
NAACOS is convening a workgroup of ACOs who have or are interested in having federally qualified health centers (FQHCs), rural health centers (RHCs), and/or critical access hospitals (CAHs)
participate in their ACOs. This group will identify and discuss issues unique to ACOs who have these provider types in their ACOs. If you’re interested in participating, ACOs should reach out
to David Pittman. Our first meeting is scheduled for June 20.
RECORDED WEBINAR EXPLAINS NEW RISK ADJUSTMENT, BENCHMARKING POLICIES
NAACOS partnered with Validate Health and the Institute for Accountable Care to record explanatory webinars on two complex topics related to ACOs’ financial methodology: recent changes to the
hierarchical condition code (HCC) risk adjustment model and the forthcoming Accountable Care Prospective Trend. In March, CMS announced it would be moving to a new version of a risk adjustment
model, and last year the agency finalized a change to add a prospective trend update to new ACO agreement periods that start next year. NAACOS has received a number of questions about both and
what the new policies mean to ACOs. To help, below are pre-recorded webinars on both topics.
LAWMAKERS TURN ATTENTION TO GOVERNMENT FUNDING AND EXPIRING HEALTH PROGRAMS
Now that Congress has passed legislation to increase the federal debt limit, lawmakers will turn its attention to other pressing matters. Congress has until September 30 to extend funding for
federal government programs. The House and Senate Appropriations Committees will begin consideration of funding bills this week. There are also several health programs that need to be extended
prior to September 30, including:
- Community Health Centers and Health Workforce Programs
-
Community Mental Health Services and Substance Use Disorder Programs under the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and
Communities (SUPPORT) Act
- Pandemic and All-Hazards Preparedness Act (PAHPA)
- Medicaid Disproportionate Share (DSH) Hospital Cuts
NEW PRIMARY CARE MODEL ANNOUNCED
Last week, CMS announced the
Making Care Primary (MCP) model, which builds on previous primary care models and will be tested
in eight states beginning July 2024. Additional information will be made available with the request for applications (RFA) release in late summer. NAACOS has developed a
summary resource on the model for members. Unfortunately, CMS does not allow concurrent participation in MCP and
ACOs, which could harm ACO efforts to recruit new practices in states where the model is available. As stated in
NAACOS’ press release on the model, NAACOS will
continue to urge CMS to allow concurrent participation or make comparable options within the Medicare Shared Savings Program (MSSP) to coincide with the start of MCP. CMS also
published a blog following the model announcement with additional
detail on the Center for Medicare and Medicaid Innovation (CMMI) strategy to support primary care, which alludes to an ACO-based primary care model test in the future. To learn more about the
comparable options being proposed, check out our
recent blog on a hybrid primary care payment option
in MSSP.
PTAC DISCUSSES TRANSITIONAL CARE MANAGEMENT
This week, the Physician-Focused Payment Model Technical Advisory Committee (PTAC) held its
June public meeting, focused on the topic of improving management of care
transitions in population-based models, including discussions of payment models and financial incentives that support transitional care management (TCM). TCM is a key tool that ACOs employ to
improve quality and reduce costs and several
NAACOS members participated in listening
sessions and panel discussions during the two-day meeting. Presentation
slides are available and session recordings will be made available on the
PTAC website in the coming weeks.
CMS TO HOST HL7 FHIR CONNECTATHON JULY 18-20
Adoption of Health Level Seven (HL7) Fast Healthcare Interoperability Resources (FHIR) is rapidly accelerating as FHIR provides a path for meeting federal interoperability and patient access
rules. CMS will host its 4th annual HL7 FHIR Connectathon on July 18–20, bringing together developers, programmers, technology experts, and CMS to test emerging FHIR Application Programming
Interfaces (APIs) and supporting FHIR implementation guides. More information, including registration details, is available. You
can participate by testing your application or as an observer to learn more about FHIR and FHIR Implementation Guides developed by the Da Vinci Project and its real-world uses. Registration
closes June 30.
CMS RELEASES QUALITY MEASURE INFORMATION FOR CMMI MODELS
For the first time, CMS released detailed information on quality measures used for 12 CMMI models and demonstrations. The measures are available in the
CMS Measures Inventory Tool (CMIT) which is a repository of CMS quality measures information and includes measure numerator,
denominator, and exclusion information. CMMI plans to update this information annually.
MORE PART B DRUGS SUBJECT TO REBATES, LOWER COST SHARING
CMS announced an updated list of 43 drugs subject to rebates to
Medicare and lower Part B coinsurance for patients starting July 1. The rebates and lower cost sharing are part of the
Inflation Reduction Act, which aims to reduce drug prices by
discouraging drugmakers from increasing product prices faster than inflation. That number is double what it previously was.
REGISTRATION NOW OPEN FOR FALL 2023 CONFERENCE!
Join us September 20-22, 2023 at the Marriott Marquis Washington, D.C., for the fall conference! In
addition to plenaries with CMS officials and value-based care leaders, 16 breakout sessions will deliver actionable knowledge for all ACOs including the MSSP and REACH models, rural ACOs, and
independent primary care ACOs. Agenda topics have been announced! Virtual and in-person registration options are available and, as
always, the entire conference will be recorded.
Register early and save! Register before August 4 for the in-person or virtual conference and receive a
discount.
Exhibitor and sponsor opportunities are now available and going fast! The conference will feature exhibitors with products and services specifically for the accountable care
community. Check out the prospectus for new and fun opportunities as partners.
Partners reserve your space today!
ASSESSING APM OPPORTUNITIES ACROSS ORGANIZATIONAL CAPABILITIES WEBINAR
JOIN US on July 10, 2023, from 1:00–2:00 pm ET for a discussion on determining which CMS or other
payor programs are best for your ACO to participate in. Emily Brower, SVP, Clinical Integration and Physician Services, Trinity Health, and Mark Angelo, MD, MHA, FACP, President & CEO,
Delaware Valley ACO will discuss how their ACOs make participation decisions, including the differences in approach by organizational structure. Jennifer Moore, MBA, President of the
MaineHealth Accountable Care Organization, will also join to moderate the discussion. Please send any questions you may have for this portion of the session to Melody Danko-Holsomback, VP of
Education, NAACOS, [email protected] by July 1, 2023. If time permits
additional questions can be asked. Register today!
UNDERSTANDING THE NEW BENEFICIARY NOTIFICATION REQUIREMENTS IN MSSP WEBINAR
Join us on June 29 from 2:00-3:00pm ET for an informative webinar on the MSSP beneficiary
notification requirements. As part of the latest Medicare Physician Fee Schedule final rule, CMS established new beneficiary notification requirements for MSSP participants which went into
effect January 1, 2023. This webinar will provide key details to support ACOs in operationalizing the new requirements. First, NAACOS will provide an overview of the recent changes, followed
by a discussion with CMS. John Pilotte, Director of the Performance-Based Payment Policy Group and Cathy LaRuffa, Director of the Division of ACO Management & Compliance with the Center
for Medicare will discuss the intent of the requirements, clarify questions on recent guidance documents, and answer audience questions. Finally, NAACOS members will provide the ACO
perspective, share approaches for addressing the requirements, and reflect on challenges and lessons learned.
Register today to secure your spot!
SUMMER AFFINITY GROUP REMINDER AND SIGN-UP
Our summer affinity group series will be under way soon. If you have not already done so and would like to join one or more sessions, simply click the links below to sign up for the group or
groups of your choice. If you have previously signed up for a session, you can use the same zoom link for the upcoming session. Check out the sessions dates for both summer and fall sessions
below.
Operations Affinity Group
June 27 and October 31 from 3:00–4:00 pm ET
Participants include managers and others who oversee day-to-day aspects of running an ACO such as building provider networks, engaging patients, practice transformation, and implementing
projects to achieve the ACO’s financial and strategic goals, etc.
Sign up for the Operations Affinity Group.
Quality Affinity Group
July 11 and November 7 from 3:00–4:00 pm ET
Participants should include managers and others who implement initiatives designed to improve, measure, and report the quality of care in an ACO, etc. Sign up for the
Quality Affinity Group.
Data and Analytics Affinity Group
July 18 and November 14 from 3:00–4:00 pm ET
Participants should include managers within ACOs who are responsible for integration, using data to analyze performance, creating and integrating data from sources like EMRs, claims and
registries, etc.
Sign up for the Data and Analytics Affinity Group.
Executive Affinity Group
July 25 and November 21 from 3:00–4:00 pm ET
Participants should include CEOs, CFOs, Executive Directors, Chief Value Officers, and others who oversee the ACO’s finances, budget, strategy, contracting, etc.
Sign up for the Executive Affinity Group.
CMO and Clinical Affinity Group
August 1 and November 28 from 3:00–4:00 pm ET
Participants should include CMOs, CNOs, Pop Health Officers, and others who manage patient care, and clinical care redesign, etc.
Sign up for the Clinical Affinity Group.
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WHAT WE’RE WATCHING: NEWS ABOUT ACOS AND HEALTH CARE
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Follow the Alliance for Value-Based Patient Care on social media. This multistakeholder coalition led by NAACOS promotes value-based care to policymakers. The Alliance will post
updates and stories on Twitter and
LinkedIn that you’ll want to follow!
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Three new members of the Medicare Payment Advisory Commission were announced recently.
The influential body makes recommendations on payment policies in Medicare.
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CMS held its inaugural Health Equity Conference last week, with leadership from across the
centers sharing recent efforts to embed health equity in CMS programs, collaborate with community partners, and advance data and evidence that support equity solutions.
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The Kaiser Family Foundation (KFF) recently released an issue brief,
Medicaid Waiver Tracker: Approved and Pending Section 1115 Waivers by State
.
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Recent Health Affairs article, ”
Policy Design Tools For Achieving Equity Through Value-Based Payment, Part 1,
” discusses key considerations for organizational participation, payment rules, and risk adjustment in value-based payment models.
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The Medicare Payment Advisory Commission (MedPAC) will release their June 2023 Report to Congress on
Thursday. The June reports focus on Medicare and the Health Care Delivery System.
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