NAACOS ACO GUIDE TO MACRA: 2020 EDITION NAACOS has developed the ACO Guide to MACRA to assist members in understanding MACRA’s Quality Payment Program (QPP) policies as they relate to ACOs specifically. This guide is published annually to reflect CMS policy changes in the QPP; NAACOS has just released the 2020 edition of the guide. In this resource, members can learn about Advanced Alternative Payment Models (APMs), how the QP calculation is completed and how Merit-Based Incentive Payment System (MIPS) policies apply to ACOs.
ATTEND NAACOS EVENTS TO SUCCEED IN VALUE-BASED CARE NAACOS two upcoming events are designed to teach ACOs, direct contracting entities, and other health care organizations how to succeed in value-based payment strategies.
Essential Tools for Financial Success with Risk-taking February 24-25 in Orlando The next in our highly popular boot camp series includes case studies, labs, and small group exercises to create an interactive and highly educational format.
NAACOS Spring 2020 Conference: A Vision for the Future of Accountable Care April 2-3 in Baltimore Register before February 7 to save $300! Join more than 650 health care leaders for a two-day look into the tools and strategies for achieving a future where quality is better, costs are lower, and patients are engaged. Our semi-annual conferences feature presentations by noted ACO experts and CMS officials, networking, peer-to-peer learning, and more than 60 exhibitors!
OVERUSE AND TRUST – REDUCING THE USE OF LOW VALUE CARE IN ACOS The Institute for Accountable Care (IAC) is looking for ACOs who are interested in reducing the use of low value care as part of their efforts to reduce costs and improve quality for a planning group. More specifically, we would like to work with six-to-ten ACOs with an interest in this area to help design a study to assess the effectiveness of these models for ACOs. Low value services can include everything from unnecessary imaging to unneeded surgeries. The planning committee will work together to identify important type of low value care to focus on, strategies to reduce the use of these services, and important learning objectives for the ACO community. Participates will have access to experts from the ABIM Foundation and Kaiser Permanente/MacColl Institutes and also have an opportunity to participate in a survey of high-value culture in your organization. The group will meet four times, including one in-person meeting at the NAACOS Spring 2020 conference. If you are interested, please reach out to Leslie Valera at lzv@institute4ac.org.
LAST CHANCE TO SUBMIT TO BEST PRACTICES FOR NACCOS SPRING 2020 CONFERENCE Friday, January 31 is the deadline for submission to NAACOS solicitation for “Best Practice” submissions for the Spring 2020 Conference. The conference will feature three 45-minute sessions where the chosen best practices in three topics, Social Determinants of Health, ESRD and Behavioral Health, will be presented. For the purpose of this solicitation, NAACOS is defining best practices as a process or set of procedures with demonstrated effectiveness in achieving a goal. The submissions are in three parts, similar to the call for innovations: a problem statement, a description of the process, and the results. Please note, the submission cannot be vendor-focused and those most likely to be chosen will use a solution that can either be created in-house or that many different vendors can provide. Vendors are not allowed to submit or present innovations. If you have any questions, please contact Anna LaFayette.
ACCESS NAACOS’ DIRECT CONTRACTING RESOURSES Sign-up now for the second webinar in NAACOS’s Direct Contracting Taskforce’s Navigating the Model Matrix series. That webinar will be held on February 6 at noon ET and will provide an in-depth discussion on new payment models from the Center for Medicare and Medicaid Innovation, including strategies for participation in multiple models. The 101 webinar, which is now available on-demand, provided a high-level review of new models, including Direct Contracting, Primary Care First, Kidney Care Choices and other APMs and discussed how each of these models interact and overlap with ACO models.
NAACOS’ Direct Contracting Taskforce has several resources already available, including a series of Frequently Asked Questions, an In-Depth Review of the Direct Contracting Model, a 75-minute overview webinar, and a chart comparing Direct Contracting and other ACOs with greater financial risk. As we formally announced last month, the Taskforce aims to help providers and healthcare organizations fully prepare to assess and participate in this new model by offering a number of resources. We are also advocating to CMS to improve aspects of the model before the start of the first performance year in 2021.
NAACOS MEMBER RESOURCES BELONG TO EVERYONE IN YOUR ACO Is there a new hire or recent promotion to your team? Are you tired of forwarding all of NAACOS’ latest and greatest updates? Did you know NAACOS resources are available to everyone at your ACO? Newsletters, webinars, policy and data papers, the works! Simply email us at support@naacos.com, and we will grant them access to the membership portal today.
NAACOS SUPPORTS RULE THAT ENCOURAGES HEALTH DATA EXCHANGE In a letter to HHS Secretary Alex Azar and others, NAACOS joined more than two dozen other organizations asking that two rules aimed at increasing the interoperability of electronic health data be finalized without further delay. Specifically, the letter supports greater us of application programming interfaces (APIs), which make it easier for different software systems to communicate with each other. APIs in health care could allow for electronic records systems to more easily share data with patients and providers through third-party applications. In June, NAACOS filed public comments to CMS and HHS’s Office of the National Coordinator for Health IT responding to proposed rules on greater health information exchange.
LEGISLATIVE WORK CONTINUES ADMIDST IMPEACHMENT TRIAL While the Senate impeachment trial continues to dominate headlines in Washington, lawmakers are working behind the scenes on a number of health priorities. Congress has until May 22 to extend a number of Medicare, Medicaid, and public health programs. The leaders of the House Ways and Means and Energy and Commerce Committees are negotiating a package of proposals to address surprise medical billing. Speaker Pelosi (D-CA) has said she wants the House to consider surprise billing legislation in the coming weeks. The Speaker’s office also said they would like to reopen drug price talks with the White House once the Senate impeachment trial concludes. Senior staff suggested negotiating broad bipartisan drug pricing legislation that could be included in a May health care package. House and Senate appropriators are also preparing to begin working on Fiscal Year 2021 spending bills once the President’s budget is released on Februrary 10.
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MEDPAC DISCUSSES ACO ASSIGNMENT At its regular January meeting, the Medicare Payment Advisory Commission (MedPAC) was in relative agreement that the Medicare Shared Savings Program (MSSP) should allow participation at the National Provider Identifier (NPI) level, a policy change for which NAACOS has repeatedly advocated. MSSP uses Tax Identification Numbers (TINs) to calculate benchmarks and spending today, but MedPAC believes clinicians could enter or leave TINs to show higher spending in a benchmark year and lower spending in an ACO’s performance year. By using TIN/NPI combinations, as the Next Generation ACO Model does and Direct Contracting will allow, clinicians could selectively bill expensive patients using a TIN outside of the ACO. A better way, which staff presented and commissioners agreed, is to use NPIs for benchmark calculations and beneficiary assignment. MedPAC has been discussing ways to improve ACO attribution to better reflect performance. A formal recommendation would come in its June report to Congress. It’s important to note that while MedPAC plays a prominent role in health policy by making recommendations to Congress, those recommendations are not binding, and Congress or the Administration must take action to enact policy changes.
SUPREME COURT DECLINES TO EXPEDITE ACA CASE In a recent decision by the Supreme Court, justices denied to fast-track hearing the Affordable Care Act (ACA) case, Texas v. United States. The case focuses on whether the overall ACA remains constitutional after a subsequent law removed the financial penalties for the individual mandate to have health insurance. Rejecting the request for an expedited review means the case likely won’t be decided before the 2020 presidential election.
