NAACOS Newsletter for Members and Partners November 17, 2022

Table of Contents

NAACOS ADVOCACY

Ask Lawmakers to Extend 5 Percent APM Incentive Payment
November DC Learning Discussion Focuses on Trend Adjustment

CONGRESSIONAL UPDATES

Key Take Aways from the Mid-Term Election
Congress Returns for Lame Duck Session
Senate Finance Releases Draft Mental Health Legislation

ADMINISTRATION UPDATES

Innovation Center Releases Strategic Vision Refresh
Next Gen ACOs Generated Savings Again in 2021
Office of Minority Health Releases Health Equity Data Plan
CMS Issues Updated PY 2021 Quality Scores
COVID-19 PHE Appears to Be Renewed Again

EDUCATION OPPORTUNITIES

Winter 2023 Boot Camp Registration Filling Up
Spring 2023 Conference Registration Opens
Final Executive and Clinical Affinity Group Meetings of 2022
Virtual Medicaid Learning Lab on December 2, Now with CEU
Upcoming Webinar on Healthier Patients and Bottom Line

MEMBER RESOURCES

NAACOS Resources Address 3-Day Waiver Questions
Annual Meeting of Members: Archived Webinar Available

WHAT WE’RE WATCHING: NEWS ABOUT ACOS AND HEALTH CARE

NAACOS ADVOCACY


ASK LAWMAKERS TO EXTEND 5 PERCENT APM INCENTIVE PAYMENT
Lawmakers returned to Washington this week to begin considering end-of-year legislative priorities. While we continue to hear from congressional staff that an extension of the 5 percent Advanced Alternative Payment Model (APM) incentive payment is on the agenda, there is a long list of health-related priorities that need to be addressed this year. Accordingly, we must continue to make our voices heard by contacting lawmakers. Please use the resources available at the Alliance for Value-Based Patient Care to contact your lawmakers and ask that they extend the Advanced APM incentive payments. If you need support in reaching out to the health staff in your lawmaker’s office, contact Robert Daley.

NOVEMBER DC LEARNING DISCUSSION FOCUSE ON TREND ADJUSTMENT
NAACOS’ November Direct Contracting (DC) Learning Discussion will take place this Friday, November 18 from 12:00–1:00 pm ET. Participation is limited to those participating in Direct Contracting in 2022 and advanced registration is required. If you have questions or additional topics you want discussed, please share them in advance by emailing [email protected].

CONGRESSIONAL UPDATES

KEY TAKE AWAYS FROM THE MID-TERM ELECTION
NAACOS’ primary legislative champions all won their races in last week’s mid-term election, with Reps. Peter Welch (D-VT) and Markwayne Mullin (R-OK) being elected to the U.S. Senate. Despite many political predictions, last week’s election also did not result in a “red wave”. Control of Congress remains split, with Republicans winning narrow control of the House and Democrats maintain a slim majority in the Senate. These dynamics will require lawmakers in both parties to work in a bipartisan manner to advance legislative in anticipation of the 2024 election when the 118th Congress convenes in January.

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CONGRESS RETURNS FOR LAME DUCK SESSION
Lawmakers returned to Washington this week for the final legislative sprint of the year. Now that the House majority is settled, Congress will need to determine a path forward to address the expiration of the continuing resolution (CR) funding the federal government, which will expire on December 16. Policies like averting Medicare physician payment cuts, the extension of the Advanced APM financial incentive payment, and Medicare extenders remain under consideration for the year-end package.

SENATE FINANCE RELEASES DRAFT MENTAL HEALTH LEGISLATION
The Senate Finance Committee released a bipartisan discussion draft of legislation that would create better care integration between mental and physical health care, including through value-based payment models. The discussion draft:
  • Supports the adoption of behavioral health integration as one of the types of opportunities that the CMS Center for Medicare and Medicaid Innovation (Innovation Center) must consider when developing new models or revising existing models,
  • Requires that CMS issue guidance to health care providers on best practices for integrating behavioral health care into the primary care setting, and
  • Supports the development of Medicare quality measures that assess the degree to which clinician practices are integrating behavioral health and primary care.
ADMINISTRATIVE UPDATES

INNOVATION CENTER RELEASES STRATEGIC VISION REFRESH
The Innovation Center recently released a report and blog post outlining a refreshed strategic vision and objectives. The report and blog post include a focus on the role of specialty care in the delivery of accountable care, including using bundles and shadow bundles within accountable care models and emphasizing the need for specialist data and transparency around performance. Specifically, four areas are highlighted:
  • Enhancing transparency in clinician performance
  • Continuing deployment of acute care episode-based payment models that align with ACOs, including mandatory models
  • Supporting specialists to engage in primary care focused models
  • Creating incentives within population-based models to encourage specialty care integration
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NEXT GEN ACOS GENERATED SAVINGS AGAIN IN 2021
Earlier this month, the Innovation Center publicly released results for the Next Generation (Next Gen) ACO Model in 2021, the final year of the model. Thirty-five Next Gen ACOs cared for just over 1 million patients and $237 million in gross savings. Across the duration of the model, $1.8 billion in gross savings were generated. NAACOS continues to advocate that successful elements of this model be permanently incorporated into other CMS ACO programs. NAACOS congratulates these ACOs for their success.

OFFICE OF MINORITY HEALTH RELEASES NEW HEALTH EQUITY DATA PLAN
The CMS Office of Minority Health detailed new health equity data efforts across CMS programs, outlining available health equity data elements, current gaps in data quality, accuracy, and completeness, and plans to address these data issues to achieve its future vision for health equity data. This addresses the first priority under the CMS Framework for Health Equity.

CMS ISSUES UPDATED PY 2021 QUALITY SCORES
CMS released updated Performance Year (PY) 2021 ACO Quality Performance Reports to inform ACOs of updates to scores resulting from certain measure benchmark calculation errors. These updates will not impact ACOs’ financial reconciliations/shared savings as the Extreme and Uncontrollable Circumstances policy is in place for 2021 due to the COVID-19 Public Health Emergency (PHE), holding all ACOs harmless from failure to meet the quality performance standard. The updated reports are available to download in the ACO Management System (ACO-MS). Please share the impact this change had on your quality scores by emailing [email protected].


COVID-19 PHE APPEARS TO BE RENEWED AGAIN
The Biden administration has promised at least a 60-day window before allowing the PHE to expire. That 60-day notice passed last week with no indication, signaling they intend to renew it again on January 11. That would extend the PHE into mid-April.

EDUCATION OPPORTUNITIES

WINTER 2023 BOOT CAMP REGISTRATION FILLING UP
Join us at the Marriott Orlando Airport Lakeside, February 9–10, 2023, for our Winter Boot Camp. The boot camp will provide expert insight into the core competencies for ACOs. Faculty from top-performing ACOs, including Baylor Scott & White, Geisinger Health, Trinity Health, ChristianaCare, and NOMS, will present clinical and operational strategies for success in any value-based care model. Participants will learn about clinical improvement models, their outcomes, and implementation tips and tricks. The format will include presentations by clinical and operational leaders in accountable care, along with case studies, and peer-to-peer learning. Boot camp topics and speakers have been announced and the full agenda is set to come in the upcoming weeks. **This boot camp will only be offered for in person. There will be no virtual option. Boot camps are not open to business partners. Space is limited to 100 people.** Register NOW!

SPRING 2023 CONFERENCE REGISTRATION OPENS
Join us May 3–5 for the NAACOS Spring 2023 Conference at the Hilton Baltimore Inner Harbor. This two-day, in-person event with pre-conference activities will feature the insights of CMS officials, ACO leaders, and policy insiders, and it also provides extensive networking opportunities for participants, speakers, and vendors. Virtual and in-person registration options are available and, as always, the entire conference will be recorded. Register early and save! Register before March 17 for the in-person or virtual conference and receive a discount.

Exhibitor and sponsor opportunities are now available! The conference will feature exhibitors with products and services specifically for the accountable care community. Partners reserve your space today!

Welcome New ACO Members

Horizon ACO REACH
Goshen, NY

INTEGRIS Health Partners
Oklahoma City, OK

Lifeprint Accountable Care Organization
Phoenix, AZ
FINAL EXECUTIVE AND CLINICAL AFFINITY GROUP MEETINGS OF 2022
New participants can still register for the last two NAACOS Affinity Group meeting this year! We recently completed the Operations, Quality, and Data and Analytics Affinity Group meetings for 2022 and had some great conversations. Don’t miss your opportunity to join these virtual meetings that provide peers in similar career positions in value-based care with a forum to meet and discuss hot topics, network, and exchange ideas. They are offered virtually between conferences for members only and in-person at our spring and fall conferences for all conference ACO attendees. You can sign-up for any of the groups and receive information for upcoming virtual meetings. Use the links below to join our the Executive or Clinical/CMO meetings in 2022. Once you sign up, the meeting link will work for all future meetings for that group. Please make sure to add the appointments to your calendars. VIRTUAL MEDICAID LEARNING LAB ON DECEMBER 2, NOW WITH CEU
Register to join the Learning Lab series on Medicaid contracting and patient management. The virtual meetings in this series begin on December 2 and will continue in monthly 90-minute sessions over the next 12-to-15 months. The Learning Lab will provide content on value-based care models to support your contracted populations and networks, various Medicaid models throughout the states, workflow options for value-based care related to primary care, social determinants of health, behavioral health, and high needs people, plus how to improve quality in the Medicaid population and how to enhance patient engagement in the Medicaid population. Our first virtual session on December 2 will feature Chad Boult, MD, MPH, MBA, creator of the “Guided Care Model”. We are now offering CEUs for this and other Learning Labs for those who attend at least 75 percent of meetings. Join the conversation to learn about patient management and contract needs for Medicaid populations and beyond.

HEALTHIER PATIENTS AND BOTTOM LINE: A REAL JOURNEY TO VALUE
Webinar Sponsored by Oracle Cerner
Between the pressures of escalating costs, an aging population, health care delivery disruption and increased regulatory demands, many are feeling the weight of an unsustainable health care system. So how are you juggling today’s health care demands? One health system turned to value-based care strategies. Join Hackensack Meridian Health (HMH), the largest health system In New Jersey, as they discuss their choice to transform their health care delivery. Patrick Young, president of population health at HMH, will discuss their ongoing value-based care journey, how they are connecting their health care ecosystem, value-based care strategies that have improved health care for their population and enhanced financial sustainability, and essential components to diversify from fee-for-service to a value-based delivery model. Register today and join us on December 6, 2:00–3:00 pm ET. This webinar is open to NAACOS ACO members.


MEMBER RESOURCES

NAACOS RESOURCES ADDRESS 3-DAY WAIVER QUESTIONS
Skilled nursing facility (SNF) waiver contract and patient management is complicated given exceptions created during the PHE and the possible elimination of those sometime in 2023. NAACOS resources on SNF waiver management include the archived webinar on Optimizing the 3-Day SNF Waivers: Perspectives from Next Gen ACOs and Spring 2022 Conference sessions on building post-acute networks. We have also recently noted several comments on the listserv about when SNFs need to be dropped from the ACO list in ACO-MS among other questions. We are currently planning a webinar on these topics for December. Watch for email promotions and future newsletter articles to sign up!

ANNUAL MEETING OF MEMBERS: ARCHIVED WEBINAR AVAILABLE
NAACOS Annual Meeting of ACO members was held on November 15. Watch the recording for an overview of current membership statistics, results from our recent satisfaction survey, advocacy activities on behalf of ACOs, and expanded education benefits. The meeting also included a report on NAACOS strategic priorities developed earlier this year by the board of directors.

WHAT WE’RE WATCHING

Here are this week’s highlights of top stories in value-based health care:
  • A recent Health Affairs Forefront piece details strategies to advance health equity through value-based payment (VBP) model design, implementation and evaluation. Authors discuss equity-focused strategies for attributing patients to VBP models, engaging stakeholders in the design and implementation process, and supporting providers in the development of cross-sectoral partnerships to address social needs and drivers of health.
  • The Health Care Payment Learning and Action Network (LAN) hosted its annual summit virtually November 9–10 with key speakers from across the CMS leadership team. Speakers discussed key issues including the future of value-based care across CMS programs, the new specialty care integration strategy, and multi-payer alignment. Session recordings will be made available soon.