NAACOS Newsletter for Members and Partners June 29, 2023

Table of Contents

Single Entity Board Seat Call for Nominations Ends July 12

NAACOS ADVOCACY

House Committee Holds Hearing on Medicare Payment Policies
Help NAACOS Elevate Our Voice on Key Topics
Join Today’s Discussion with CMS on MSSP’s Beneficiary Notification
NAACOS Submits Feedback on Duals Discussion Draft Legislation

CONGRESSIONAL UPDATES

Lawmakers Return in July with Long List of Priorities
Medicare Advisors Send June Report to Congress

ADMINISTRATION UPDATES

OIG Releases Final Rules on Information Blocking
ESRD Proposed Rule Released by CMS
Partnership for Quality Measurement Launched
Enhancing Oncology Model Participants Announced
Check Your 2022 QPP Preview Reports
CMS Hosts MCP Model Overview Webinar

EDUCATIONAL EVENTS

Workshops and Agenda Announced for Fall 2023 Conference
Save the Date for Webinar on Assessing APM Opportunities
Discovery Call on QCDR Scheduled for July 24
Affinity Group Summer Sessions Begin This Week

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


SINGLE ENTITY BOARD SEAT CALL FOR NOMINATIONS ENDS JULY 12
NAACOS is soliciting nominations for our 2024 board member election for single entity ACO representatives only, which will open in August. To be a NAACOS board member, the candidate must be employed as an executive of a NAACOS member ACO in good standing now and during the term of office. For the 2024 Board, the election will fill two ACO single entity board seats. ANYONE may nominate someone for the single entity representative board seat, but only single entity ACOs will vote for these representatives. Expectations for board members, as well as the information about what needs to be submitted is available. Self-nominations are permitted and preferred. The call for nominations will close on July 12.

NAACOS ADVOCACY

HOUSE COMMITTEE HOLDS HEARING ON MEDICARE PAYMENT POLICIES
The House Energy and Commerce Oversight and Investigations Subcommittee held a hearing last week discussing implementation of the Medicare Access and CHIP Reauthorization Act (MACRA). NAACOS was invited to testify before the subcommittee to answer questions about implementing alternative payment models (APMs), including ACOs. Aisha Pittman, senior vice president of government affairs, represented NAACOS at the hearing which was a tremendous opportunity for NAACOS to advocate for continued incentives for practices in APMs, along with discussing ways that Congress can improve Medicare’s payment system to advance value. 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 advocacy@naacos.com if you have implemented strategies in these areas, which 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 has helped you reshape care teams to reduce clinician burden
JOIN TODAY’S DISCUSSION WITH CMS ON MSSP’S BENEFICIARY NOTIFICATION
This afternoon at 2:00pm ET, NAACOS will host an informative webinar featuring CMS speakers John Pilotte, director of the Performance-Based Payment Policy Group, and Cathy LaRuffa, director of the Division of ACO Management and Compliance at the Center for Medicare, to discuss recent changes to the beneficiary notification requirements in the Medicare Shared Savings Program (MSSP). It’s not too late to register! For those unable to attend the session live, a recording and a copy of the slides will be made available.


NAACOS SUBMITS FEEDBACK ON DUALS DISCUSSION DRAFT LEGISLATION
This week, NAACOS provided feedback to a group of senators working on legislation to improve the quality of care for individuals dually eligible for Medicare and Medicaid. The senators initially solicited feedback through a public request for information (RFI) in late 2022, on which NAACOS provided comments. This spring, the offices followed up with NAACOS to seek feedback on draft legislation that would, among other things, require states to implement integrated care programs for duals in collaboration with the Medicare-Medicaid Coordination Office. NAACOS’ comments highlight the need for alignment across Medicare and Medicaid, rather than creating separate requirements for duals programs, and for policies that facilitate ACOs’ ability to contract with states to provide integrated care for duals.

CONGRESSIONAL UPDATES

LAWMAKERS RETURN IN JULY WITH LONG LIST OF PRIORITIES
The House and Senate are in recess until July 12. When lawmakers return to Washington, attention will turn to passing Fiscal Year 2024 spending bills and debating expiring health programs. NAACOS is also working with members in the House to reintroduce the Value in Health Care Act in July. The updated version of the bill will focus on developing effective benchmark guardrails for ACOs, extending APM incentives, and studying ways to increase parity between APMs and Medicare Advantage.

MEDICARE ADVISORS SEND JUNE REPORT TO CONGRESS
The Medicare Payment Advisory Commission (MedPAC) sent its June Report to Congress. The report includes an overview of Medicare’s health delivery system and includes chapters on telehealth, drug coverage, Medicare Advantage, behavioral health, telehealth, and reforming Medicare payments.
  • Recommendations. The report recommends that Congress more closely align payment rates across ambulatory settings and repeal the existing Medicare wage index statutes. It also highlights that Medicare should consider reducing telehealth payment rates and gather more data to shape future reimbursements.
  • ACOs and behavioral health. The report also includes a chapter on behavioral health that highlights studies showing how ACOs have not yet fully integrated these types of services into primary care models.
    • NAACOS wants to hear how your ACO is addressing behavioral health challenges. Please reach out to advocacy@naacos.com and share your ACO’s story.
ADMINISTRATION UPDATES

OIG RELEASES FINAL RULES ON INFORMATION BLOCKING
The Department of Health and Human Services Office of Inspector General (HHS-OIG) released a final rule implementing information blocking penalties created by the 21st Century Cures Act. Enforcement will begin 60 days following publication of the final rule in the Federal Register. The final rule amends the civil money penalty regulations and its penalties apply to health information exchanges, health information networks, and IT developers with certified health IT products. It is expected that a proposed rule regarding fines for health care providers related to information blocking will be released this fall. The rule explains the OIG’s approach to enforcement, which will focus on information blocking allegations that pose greater risk to patients, providers and health care programs as well as OIG’s anticipated consultation with the Office of the National Coordinator for Health Information Technology (ONC) in reviewing and investigating allegations. More information is available.


ESRD PROPOSED RULE RELEASED BY CMS
On June 26, CMS released the Calendar Year 2024 end-stage renal disease (ESRD) Prospective Payment System (PPS) for renal dialysis services. CMS is proposing to increase the ESRD PPS base rate to $269.99, increasing total payments to ESRD facilities by approximately 1.6 percent. The CMS fact sheet and proposed rule are available. Comments are due by August 25.

PARTNERSHIP FOR QUALITY MEASUREMENT LAUNCHES
The Partnership for Quality Measurement (PQM) will replace the National Quality Forum’s consensus-based endorsement and maintenance process for quality measures used in CMS programs. The new process will be launched this fall. The new contractor, Battelle, will hold an informational webinar on these changes on June 30 at 12:00 pm ET. More information regarding membership opportunities is available on the PQM website.

ENHANCING ONCOLOGY MODEL PARTICIPANTS ANNOUNCED
CMS has named the 67 oncology physician group practices participating in the new Enhancing Oncology Model (EOM) that starts on July 1. This represents 600 sites of care and more than 3,000 clinicians. According to CMS, a little over half of EOM’s participants were previously in the Oncology Care Model. NAACOS offers a summary of the voluntary, five-year model.

CHECK YOUR 2022 QPP PREVIEW REPORTS
CMS has provided final Performance Year (PY) 2022 Merit-based Incentive Payment System (MIPS) scores, available on the Quality Payment Program (QPP) portal. During the MIPS Final Score Preview Period, clinicians and ACOs can review final scores in advance of the corresponding 2024 payment adjustments taking effect. Final scores and payment adjustment information will be released in August 2023. Please check your scores and share if you find any discrepancies or errors by emailing us at advocacy@naacos.com. You should also contact the QPP Service Center with any errors or issues at QPP@cms.hhs.gov. Note scores are not final and could change between now and August if CMS identifies issues during this preview period that require system-wide scoring changes. Following the final adjustment information shared in August, there will be a 60-day targeted review period during which you can contest your score. CMS also posted the PY 2021 QPP Experience Report.

CMS HOSTS MCP MODEL OVERVIEW WEBINAR
On June 27, CMS hosted a webinar to provide additional information about the recently-announced Making Care Primary (MCP) Model, which launches July 1, 2024. For those who were unable to attend, a recording and slides will be made available shortly. Organizations interested in participating in MCP can now submit a non-binding letter of intent to the Center for Medicare and Medicaid Innovation (CMMI). More information on MCP and the model’s implications for ACOs is available.


EDUCATION OPPORTUNITIES

WORKSHOP AND AGENDA ANNOUNCED FOR FALL 2023 CONFERENCE
Join us September 20–22, 2023 at the Marriott Marquis Washington, D.C. for the fall conference! Pre-conference indepth workshops will be held September 20 from 1:00 to 5:00 pm ET. The workshop topics are MA and Other ACO Contracts; Specialist Engagement; and Reporting eCQMs. In addition to our workshops and plenaries with CMS officials and other value-based care leaders, 16 breakout sessions will deliver actionable knowledge for new and experienced ACOs in all models. Full agenda is now available!

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 either the in-person or virtual conference and receive a discount.

Exhibitor and sponsor opportunities are 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 and reserve your space today!

SAVE THE DATE FOR WEBINAR ON ASSESSING APM OPPORTUNITIES
Today’s ACOs are participating in more than just Medicare ACOs, and many of our members want to understand how their peers have successfully handled this. NAACOS will host a webinar on July 10 from 1:00–2:00 pm ET on determining which CMS or other payor program is best for your ACO. 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 moderate the discussion. Please send any questions for the speakers in advance to Melody Danko-Holsomback, VP of Education, NAACOS, by July 1, 2023. If time permits during the webinar, additional questions can be asked. Register Now!

DISCOVERY CALL ON QCDR SCHEDULED FOR JULY 24
Is your ACO reporting on MIPS or are you considering using the Qualified Clinical Data Registries (QCDR) method? Are you wondering what other ACOs have done and what vendors they used to report successfully? Sign-up today for a QCDR discussion with ACO peers on July 24 from 4:00–5:00 pm ET. On this call, CarolAnn Hudson, clinical director, population health at LifePoint Health, and Willson Gabbard and team from Advocate Health will start the conversation with their experiences reporting via QCDR and the RFP process. This event is provided to follow up on numerous inquiries from members on the NAACOS ListServ.


AFFINITY GROUP SUMMER SESSIONS STARTED THIS WEEK
Following a break over the Fourth of July week, affinity groups will resume for the remainder of the summer. See below for upcoming dates and ensure they are on your calendar. If you have not signed up yet, there is still time to make this round of peer-to-peer meetings. You may sign up for more than one group if your role is diverse and you manage or work in multiple areas.

Operations Affinity Group
June 27 and October 31
3:00–4:00 pm ET
Executive Affinity Group
July 25 and November 21
3:00–4:00 pm ET.
Quality Affinity Group
July 11 and November 7
3:00–4:00 pm ET
CMO and Clinical Affinity Group
August 1 and November 28
3:00–4:00 pm ET
Data and Analytics Affinity Group
July 18 and November 14
3:00–4:00 pm ET
 


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

  • Follow The Alliance for Value-Based Patient Care on social media. This multi-stakeholder 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!
  • Recent Health Affairs article, “Policy Design Tools for Achieving Equity Through Value-Based Payment, Part 2,” discusses key considerations for performance measurement, spending targets, performance-based incentives, and care delivery redesign in value-based payment models.
  • A bipartisan group of House and Senate members reintroduced the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act. The bill expands telehealth coverage in Medicare and makes permanent the COVID-19 telehealth flexibilities.