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STAKEHOLDERS CALL ON HHS TO “FIX, DON’T END” DIRECT
CONTRACTING
NAACOS thanks all those members who signed a letter to Health and Human Services (HHS) Secretary
Xavier Becerra urging him to “fix, don’t end” Direct Contracting. At the end, 222 organizations including prominent trade groups, like NAACOS,
health systems, medical practices, Direct Contracting Entities (DCEs), ACOs, and others,
signed the letter. NAACOS had heard Secretary Becerra and the White House were weighing
the future of Direct Contracting, including the possibility of canceling the program, following backlash from advocates and progressive Democrats on
Capitol Hill. We are now cautiously optimistic that our advocacy will prevent the model
from termination, and we expect more information from CMS soon.
As the
premier accountable care model from the CMS Innovation Center, Direct Contracting is
needed to help redesign healthcare delivery and payment. We continue to work with
Capitol Hill and the administration to garner support. We will alert members when we
have more clarity about the model’s future, but for now, we expect numerous policy
details to be announced next month after a statement of support from CMS in the next few
days.
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MEENA
SESHAMANI TO OPEN NAACOS SPRING CONFERENCE
Dr. Meena
Seshamani, Deputy Administrator and Director of Center for Medicare is confirmed to open
the NAACOS Spring 2022 Conference with a keynote on Thursday, April 28 at 8:30 a.m. Join us at
the Hilton Baltimore Inner Harbor and hear from her and other leading value-based care
experts and CMS officials sharing timely and essential information for ACOs and other
alternative payment models (APMs). The conference will also include our peer-to-peer
exchanges, quality award winners, and the popular CMS Townhall to close out the
conference. A detailed agenda is
now available.
Register Early and Save
Register before March 4 for the in-person conference and receive
a discount of $300 per person. Can’t attend in person? Register for our live webcast before March 4 and receive a
discount of $100 per person. Proof of vaccination required to attend
in-person.
NAACOS TO LAUNCH LEARNING LAB
ON SPECIALIST INTEGRATION
NAACOS is launching a
Learning Lab on Specialist Engagement and Incentives on April 27 at the Hilton
Baltimore. Learning Labs are a new educational activity for members designed to provide
a deep dive into fundamental strategies in accountable care and to foster exchange among
peers with frontline experience. These interactive “labs” will include expert
presentations, experiences from member ACOs, brainstorming activities, and peer-led
collaborations. NAACOS will be an active partner in these Learning Labs to understand
what additional resources and tools members need to work through various administrative,
operational, and transformational processes.
Due to great interest from our
membership, Specialist Engagement and Incentives will be the topic for our inaugural
Learning Lab session kicking off this April with more activities and resources to follow
throughout 2022. Watch for further information on participating in the next newsletter.
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NAACOS
RESOURCE REVIEW
Questions about the 2021 MSSP quality reporting
process?
With only five weeks left to
complete MSSP 2021 quality reporting, NAACOS would like to remind ACOs
of the resources available on our Quality
page that may help with your submission.
For 2021, ACOs may choose to report either via Web Interface or via
electronic clinical quality measures (eCQMs)/Merit-Based Incentive
Payment System CQMs. All ACOs will have new scoring rules applied as the
MSSP transitions to the APM Performance Pathway (APP) quality scoring
methods beginning with Performance Year (PY) 2021. The resources found
on the NAACOS Quality page include links to the NAACOS Web Interface
Quality Guide, completed in 2020, CMS
guidance and fact sheets, Web
Interface specification documents, and the
Quality Payment
Program (QPP) resource library, as well as
the NAACOS guide to accessing
eCQM specifications. In addition, we
provide an overview of the APP for ACOs in our new resource that
explains new quality
reporting requirements and scoring rules
for 2021–2025.
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ASK YOUR
REPRESENTATIVES TO JOIN LETTER SUPPORTING ACOS BY MARCH 1
The leaders of the House Innovation Caucus are asking their House colleagues to join them in sending a letter requesting that the Biden
administration prioritize policy changes that will increase ACO participation. The
deadline for lawmakers to sign the letter is March 1. NAACOS has been asking our members to write their representatives to ask them to
sign the letter. We support the recommendations in the letter and believe these changes
will advance the Biden administration’s goals of expanding accountable care.
CMS WITHDRAWS RURAL-FOCUSED ACO
MODEL
CMS announced this week it was formally
withdrawing the ACO Transformation Track of the rural-focused Community Health and Rural
Transformation (CHART) Model. This Innovation Center model would have given up-front
funding to 20 mostly rural providers to form ACOs. Despite the announcement from CMS,
NAACOS is optimistic that CMS will launch a separate model to spur ACO development.
Unlike CHART, this new model would have a strong emphasis on addressing equity, and
NAACOS has been in touch with CMS around details of that model. NAACOS also believes CMS
could certify the ACO Investment Model, which has already been proven to save Medicare
money and improve quality. The agency says it remains committed to ACOs and has set a
goal to have all traditional Medicare beneficiaries into an accountable care model by
2030.
NEW RESEARCH SHOWS EXITING
MSSP LEADS TO LOWER QUALITY
A recent study shows that exiting the Medicare Shared Savings
Program (MSSP) was associated with lower rates of preventive services, resulting in
lower quality of care after the practice’s departure from the program. The study looked
at a cohort of more than 1.7 million beneficiaries. The reductions in clinical quality
after leaving the MSSP were found to be most prominent in the first two years after
exiting the program. After exiting the MSSP, the study shows patients were less likely
to receive important preventive screenings, particularly those associated with managing
diabetes and cardiovascular disease, for example. This study demonstrates the importance
of maintaining high levels of participation in the MSSP and similar models.
CONGRESS
MULLS UPCOMING DEADLINES
Congress is in recess
this week after passing a temporary extension of federal funding at a February 17 Senate
roll call vote of 65 yeas to 27 nays. The measure provides funding for the federal
government through March 11, setting up a quickly approaching deadline for Congress to
come to bipartisan agreement on a Fiscal Year 2022 appropriations package or pass
another temporary funding measure. Also upcoming, the 2 percent sequester cut delayed by
Congress last December, which was a significant concern for Medicare physician payment,
will be partially effective on April 1 with a 1 percent cut going into effect. And, last
week the Biden administration put forward its budgetary request to Congress on
health-related items but did not include approximately $20 billion in provider relief
funding requested by hospital associations. Of note, underlying Congress’ efforts to
meet impending deadlines and resolve issues related to funding and the public health
emergency (PHE), is the escalating situation in the Ukraine and Congress’ urgent efforts
on that issue.
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INSTITUTE
UPDATE: ACOS AND GERIATRIC EMERGENCY DEPARTMENTS
Geriatric emergency departments (GEDs) are a new
model established to enhance the care experience for vulnerable older adults and reduce
potential harms, including avoidable admission, in the fast-paced ED environment. Today,
there are more than 300 certified GEDs, and 20 percent of ACOs have at least 1,000 GED
visits per year. This creates a natural opportunity for partnerships given the common
goal of preventing avoidable hospitalizations. To learn more, see our paper published last week in Health Affairs. Other recent
publications include a discussion of challenges facing ACOs in the transition to ECQMs, a proposal to extend and enhance
the Advanced APM bonus program, and a summary of the literature on the
characteristics and performance of ACOs. If you would like a copy of these papers
use the links above or contact us at: [email protected].
BUNDLED PAYMENT EXPERT JOINS THE INSTITUTE
The Institute for Accountable Care is pleased to
announce that Dan
Koppel has joined its team as director of applied analytics. Over the past
decade Dan has worked at several firms including Remedy Partners and New Century Health
developing analytical software produces focused on bundled care pricing, care
optimization and risk modeling for clinicians in the CMS Bundled Payment for Care
Improvement and Oncology Care Models. Dan’s work will focus on expanding the Institutes
capabilities to use episode of care analytics to evaluate the performance of specialty
care providers.
UPDATED MSSP SPECIFICATIONS
RELEASED
CMS has released an updated Shared
Savings and Losses and Assignment Methodology Specifications document for MSSP (Version 10). The
resource includes updates on the MSSP beneficiary assignment and financial methodology
for PY 2022 to reflect policies finalized in the 2022 Physician Fee Schedule Rule. The
resource can be accessed on the CMS website under the resources section.
NAACOS
NEW HEALTH EQUITY WEBINAR AVAILABLE ON-DEMAND
On February 15, NAACOS hosted a webinar titled How ACOs Are Addressing Health Equity:
Insights from Innovators during which speakers from Advocate Aurora Health, Aledade, and
Mount Sinai Health System highlighted the work they are doing to close health equity
gaps among their populations. A recording of the webinar and a PDF of the slides are now available on-demand. Speakers shared key insights from their
experiences designing and implementing health equity initiatives within their ACOs. The
webinar recording also includes a robust panel discussion followed by audience
questions. This webinar is part of ongoing work by NAACOS to engage in conversations
around health equity and explore how APMs can facilitate health equity initiatives, as
well as to highlight the important work ACOs are doing to reduce health inequities.
NAACOS SUBMITS STATEMENT TO
WAYS & MEANS ON HEALTH EQUITY
Recently,
NAACOS submitted a statement for the record to the House Ways &
Means Committee in response to the recent Health Subcommittee hearing on bridging health equity gaps for
people with disabilities and chronic conditions. In this statement, NAACOS described the
history of ACOs’ work to provide high-quality, coordinated, and whole-person care to
patients with complex health needs through care management and other strategies.
Additionally, we highlighted how ACOs are uniquely positioned to identify and address
health inequities and how they are incentivized to address social factors affecting the
health outcomes of their patients. NAACOS urged the committee to consider the Value Act as an opportunity to strengthen ACOs’ ability to
engage in this work and to grow the program so that the benefits of accountable care are
accessible to more beneficiaries.
LAWMAKERS CALL ON THE BIDEN
ADMINISTRATION TO WIND DOWN PHE
As more states
move to loosen COVID-19 restrictions, calls from lawmakers in Washington are increasing
to end the federal government’s PHE, which has been extended numerous times and is
currently scheduled to expire on April 15. While the Biden administration is expected to
extend the PHE at least once more this year and provide a 60-day notice to stakeholders
before termination, a group of more than 70 congressional Republicans wrote a letter on February 10 asking the Biden administration to
outline its timeline for ending the PHE. The letter also asks for HHS to identify which
emergency flexibilities should be made permanent.
CMS has implemented
several regulatory flexibilities for ACOs during the PHE, along with temporary
telehealth policies that will expire at the end of the emergency. NAACOS sent a letter to HHS last year asking for the Biden
administration to modernize telehealth requirements and provide permanent waivers for
all ACOs, regardless of risk level or choice of attribution. There continues to be
bipartisan support in Congress for making permanent changes to telehealth policies.
NAACOS’ will continue to monitor the administration’s decision making and alert members
to any extension or the possible end of the PHE.
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