NAACOS Newsletter for Members and Partners December 15, 2022
SENATORS INTRODUCE BILL TO EXTEND 5 PERCENT ADVANCED APM INCENTIVE PAYMENTS On December 14, Senators John Barrasso (R-WY) and Sheldon Whitehouse (D-RI) introduced the Preserving Patient Access to Value-Based Care Act. The bill will extend Medicare�s 5 percent advanced Alternative Payment Method (APM) incentive payment for two years, along with keeping qualification threshold attainable for clinicians. NAACOS appreciates their leadership and looks forward to working with lawmakers to extend these critical incentives. See the NAACOS press release and Alliance for Value-Based Patient care press release. ASK CONGRESS TO EXTEND ADVANCED APM INCENTIVE PAYMENTS An extension of the 5 percent advanced APM incentive is on the end-of-year priority list for Congress. With so many issues on the agenda, please continue to make your voice heard by contacting lawmakers today. You can 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 lawmakers’ offices, contact Robert Daley. FINAL DIRECT CONTRACTING LEARNING DISCUSSION OF THE YEAR NAACOS� December Direct Contracting Learning Discussion will take place this Friday, December 16 from 12:00�1:00 pm ET. We will discuss roster management, specifically how to handle mid-year additions and drops to your provider lists, but there will be opportunities to raise other issues as well. 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]. 
LAME DUCK UPDATE As budget negotiations continue, congressional leaders are working to pass a one-week continuing resolution (CR) to give lawmakers extra time to work out the details of an end-of-year budget bill. The short-term CR will extend government funding through December 23. Congressional leaders are working around the clock to finalize legislation to fund the government for the remainder of Fiscal Year 2023. The funding bill could also be used to address a wide array of Medicare reimbursement issues, including an extension of the 5 percent advanced APM incentive and telehealth waivers. COUNTDOWN TO THE 118TH CONGRESS The next Congress will convene on January 3, and there are several changes on the horizon.
Progressive Democrats in Congress recently sent a letter to CMS that questioned the participation of nine organizations in ACO REACH given their histories of fraud and abuse. The letter was led by Rep. Pramila Jayapal (D-WA) and Sen. Elizabeth Warren (D-MA) and had 21 signatories in total. We don�t believe this letter will sway CMS�s support of ACO REACH or detract the model in other ways going forward. NAACOS has worked hard behind the scenes over the last year to limit the impact of progressives� work against ACO REACH and to support our members. Progressives� multiple letters over the course of the year have had fewer and fewer co-signers, which is likely a testament to our work. NAACOS will continue to work to build support for accountable care models, including ACO REACH, on Capitol Hill. 
REACH PARTICIPATION AGREEMENTS RELEASED The CMS Innovation Center recently released the 2023 Participation Agreements for the new ACO REACH model. NAACOS is working on a summary of the major changes, but they largely follow previously announced changes surrounding the model. ACOs have between 8:00 am ET on December 23 and 8:00 pm ET on December 28 to sign the documents in 4i. CMS RELEASES PROPOSED RULE AUTOMATING PRIOR AUTHORIZATION CMS recently released a proposed rule to enable improved access to data on prior authorization decisions, allowing providers to access their patients� data by requiring payers to build and maintain a Provider Access Fast Healthcare Interoperability Resources (FHIR) Application Programming Interface (API) to enable data exchange from payers to in-network providers when there is a treatment relationship. This would automate the process for providers to determine whether a prior authorization is required, identify prior authorization information and documentation requirements, and facilitate the exchange of prior authorization requests/decisions from the Electronic Health Record (EHR) or practice management system. If finalized, the proposed rule would apply to Medicare Advantage, state Medicaid and CHIP agencies, Medicaid managed care plans, CHIP managed care entities, and Qualified Health Plans on the federally facilitated exchange. Comments will be accepted on the proposals until March 13. More information is available in the CMS fact sheet. MIPS DATA VALIDATION AUDITS BEGIN CMS has contracted with Guidehouse to conduct data validation and audits of Merit-Based Incentive Payment System (MIPS) clinicians. Data validation audits aim to confirm the accuracy and completeness of reported results of the MIPS program. If selected for an audit, Guidehouse will send a request for information via the email address [email protected]. Clinicians have 45 days from the date of notice to provide the requested information such as copies of medical records for applicable patients or other sources used in the data calculations for MIPS measures. If you are selected for an audit, please share your feedback regarding the process with us at [email protected]. 
The CMS Innovation Center released several evaluation reports:
NAACOS ANNOUNCES NEW DIRECTOR OF MEMBERSHIP NAACOS is pleased to announce that Jen Rivera will serve as our director of membership. She has more than ten years of experience helping organizations rethink how their membership model can deliver a consistent return on investment for member organizations. Jen comes to NAACOS from the American Society on Aging, where she was the director of membership engagement, responsible for building a seamless, engaging, and impactful member experience. Throughout her professional career, she has developed an understanding of building and sustaining relationships with stakeholders and implementing strategies to grow organizations. As the director of membership, Jen will lead all activities related to establishing and maintaining relationships with accountable care models and industry partners. Please welcome Jen to the NAACOS family at [email protected]. NAACOS WELCOMES FIRST PAYER PARTNER: BLUECROSS® BLUESHIELD® OF SOUTH CAROLINA NAACOS is pleased to announce its first partnership with BlueCross� BlueShield� of South Carolina. BlueCross is a national leader in the Value Based Care arena with multiple commercial ACOs, PCMH programs, bundles, MA offerings, pay for performance programs, and specialty specific models. They are the only health insurer in South Carolina with an A.M. Best rating of A+ (Superior). With this new category of non-ACO member, NAACOS hopes to foster communication and collaboration between ACOs and payers.
PATIENT MANAGEMENT RESOURCES AVAILABLE IN NAACOS ARCHIVES Many members have asked about various aspects of patient management from how to structure virtual and in-person care management programs to remote patient monitoring. NAACOS has archived all presentations for events at conferences, boot camps , and webinars, as well as Listserv Q&A postings housed in the NAACOS KnowledgeBase. If you are in a hurry for information and can�t wait for an upcoming NAACOS event, simply search any of these for previously presented topics by fellow NAACOS members and vendors. Searching the entire NAACOS website once signed in is also very simple: just type your topic in the SEACH window in the top right corner of the NAACOS website. 
SIGN UP NOW TO JOIN THE MEDICAID LEARNING LAB AND EARN CEUS There is still time to Register for the Learning Lab series and earn CEUs on Medicaid contracting and patient management. The virtual meetings in this series began on December 2 and will continue in monthly 90-minute sessions over the next 12-to-15 months. The next meeting will occur on January 6, 2023, from 2:00 pm to 3:30 pm ET. 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 and how to enhance patient engagement in the Medicaid population. This series will offer a platform to not only gain knowledge on these topics but also create a strategic plan for implementation within your ACO. We are now offering CEUs for this and other Learning Labs to those who attend at least 75 percent of meetings. Sign up today to learn about patient management and contract needs for Medicaid populations and beyond. AGENDA NOW AVAILABLE FOR THE WINTER 2023 BOOT CAMP Join us at the Marriott Orlando Airport Lakeside, February 9-10, 2023, for the 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. Full agenda is now available! Register NOW! **This boot camp will only be offered in person. There will be no virtual option. Boot camps are not open to business partners. Space is limited to 100 people.** REGISTRATION IS NOW OPEN FOR SPRING 2023 CONFERENCE Join us May 3�5, 2023, for the NAACOS Spring 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 also provide 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!
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