NAACOS Newsletter for Members and Partners May 20, 2021

Table of Contents
Faculty Added for June Boot Camp on ACO Data
Urge CMS to Walk Back Quality Measurement Changes
Window for Notices of Intent to Apply to MSSP Opens June 1
Deadline to Apply for Primary Care First Closes Tomorrow
Register for NAACOS Webinars on Navigating the Model Matrix
Modeling Performance Requires the Right Data and Expertise
CMS Publishes Guidance on Hospitals Sharing Electronic ADT Alerts
CMS Releases Stop-Loss Information for Direct Contracting
Biden Administration Seeks Feedback on Eliminating Health Disparities
Institute Publishes Medicare Spending Trends During COVID Pandemic
Assess Your High-Value Culture


FACULTY ADDED FOR JUNE BOOT CAMP ON ACO DATA
Harnessing your data can create actionable strategies that improve your ACO’s performance. Learn from leading ACOs how to turn your data into knowledge that will guide your operations and put your ACO on the path to success. The boot camp will feature these key topics:
  • Data Analytics Platforms
    • Travis Broome, Aledade
  • ACO Data 101
    • Rob Mechanic and Jen Perloff, Institute for Accountable Care
  • Staffing Your Data Operation
    • Debbie Welle-Powell, Essentia Health
  • Conquering electronic Clinical Quality Measures (eCQMs)
    • Megan Reyna, Advocate Aurora Health
  • Using Data to Improve Care
    • Yoni Dvorkis, Atrius Health, and Tom Hawkes, Caravan
Plus learn from ACO colleagues during three Zoom debrief sessions, held throughout the two-day boot camp. An agenda has been announced and more details are being added daily. This boot camp is designed for the ACO executive team, specifically executive directors, medical directors, population health leaders, and data/analytics teams.

Boot Camp Rates:
  • $595 for individuals from ACO members
  • ACO member organizations can register up to five people for $2,000—registering at an organizational rate is only for NAACOS ACO members. Please contact Emily Perron to take advantage of this rate.
  • $795 for individuals from non-member ACOs
Register now and get your data to work for you!

URGE CMS TO WALK BACK QUALITY MEASUREMENT CHANGES
NAACOS is asking our members and business partners to take a few minutes to write HHS Secretary Xavier Becerra and ask that CMS delay changes to ACO quality reporting and make further modifications to ACO quality evaluations. To help, NAACOS has drafted a letter, which should be personalized, to share why these changes are ill-conceived and need to be revised. Don’t forget to include your organization’s name at the end. If CMS does not make changes soon, ACOs and their participants will bear significant health information technology (IT) costs and upgrades to be able to collect and report data, ACOs may drop clinicians—particularly specialists or small practices—because of additional reporting burdens and IT costs, or ACOs could drop out of the program altogether. NAACOS is advocating hard on this issue, but we could use your help. Visit our take action page now!

WINDOW FOR NOTICES OF INTENT TO APPLY TO MSSP OPENS JUNE 1
Earlier this month, CMS issued updated information on the Medicare Shared Savings Program (MSSP) application process and timeline for the January 1, 2022 start date. The Notice of Intent to Apply (NOIA) opens on June 1 and will close on June 7 at 12:00 pm ET. Be sure to gain access to the CMS ACO Management System to submit the NOIA. Following this, the Phase 1 of the application process will open on June 8. The window for this phase of the application closes June 28 at 12:00 pm ET. A CMS application toolkit is available with helpful guidance and resources. Additional information about the application timeline is available. As a reminder, application dates are subject to change.

COVID Banner

DEADLINE TO APPLY FOR PRIMARY CARE FIRST CLOSES TOMORROW
After initially extending the application period of Primary Care First (PCF) Cohort 2, the deadline is now approaching. The Request for Applications (RFA) for Cohort 2 was released in March, and the deadline for practices to apply is May 21. Access the application. Earlier this year, CMS also announced that participation in the Comprehensive Primary Care Plus (CPC+) Model would no longer be a requirement for PCF Cohort 2 eligibility, so all practices within the 26 regions that meet other requirements are eligible to apply.

There are currently 827 practices participating in Cohort 1 of PCF and 14 payer partners. Practices in both Cohort 1 and Cohort 2 will have a five-year performance period. Consistent with Tracks 1 and 2 of the CPC+ Model, practices participating in ACOs under all MSSP tracks are eligible to participate in PCF. In contrast, providers participating in the Direct Contracting Model may not simultaneously participate in PCF.

REGISTER FOR NAACOS WEBINARS ON NAVIGATING THE MODEL MATRIX
A popular NAACOS webinar series from early last year is back! NAACOS is reviving a two-part webinar series that reviews new alternative payment models (APMs) and how these models interact with one another. The first webinar, Navigating the Model Matrix: 101, is scheduled for June 2 and will provide a high-level review of key CMS Innovation Center payment models and will draw comparisons to previous, legacy models. The second webinar is scheduled for June 14 and offers a more in-depth discussion, including key decision points for ACOs evaluating participation in these models. Register today!

MODELING PERFORMANCE REQUIRES THE RIGHT DATA AND EXPERTISE
Please join us on May 26, 2021, 2:00–3:00 pm ET for a webinar sponsored by Milliman and its ACO Builder. Standard CMS Medicare ACO reports lack the richness necessary to identify top performers, develop win-win partnerships, set participant budgets, and accurately evaluate the economic impact of program changes and contract renewals. Get the insights you need to optimize your ACO. Milliman ACO Builder helps you understand participant-level performance inside and outside your ACO, including contributions to surpluses or losses. You always have access to up-to-date and complete information that leverages Milliman analytics and ACO expertise. Hear from the ACO leadership team at Health Connect Partners ACO and Providence St. Joseph Health how to:
  • Reduce risk and improve financial health
  • Forecast the financial settlement
  • Benefit from Milliman expertise
  • Evaluate economic impact
This webinar is for ACOs only. Register today!


CMS PUBLISHES GUIDANCE ON HOSPITALS SHARING ELECTRONIC ADT ALERTS
Following NAACOS’ advocacy, CMS clarified in recently published guidance that ACOs may receive electronic notifications of patients’ admission, discharge, and transfer (ADT) from an inpatient facility, as well as emergency department presentations. Hospitals’ requirement to share electronic ADT alerts was finalized last year and took effect on May 1. Those alerts should go to patients’ established primary care providers, but NAACOS had urged CMS to clarify that those alerts should go to ACOs if patients’ clinicians practice in an ACO. CMS issued guidance and a related FAQ document to help hospitals implement the new requirements. NAACOS hopes receiving ADT alerts will improve care coordination. This resource summarizes the requirement and the final rule in which it was published last year.

CMS RELEASES STOP-LOSS INFORMATION FOR DIRECT CONTRACTING
Earlier this week, all direct contracting entities received their stop-loss attachment points and charges for Performance Year 2021. Similar to the stop-loss arrangement available in the Next Generation ACO Model, stop-loss is optional for DCEs and is a protection against exceptionally high costs for any individual aligned beneficiary. DCEs electing to participate pay a per-beneficiary charge for the protection. Notably, to account for the nine-month performance year in 2021, the Innovation Center will apply a retrospective adjustment that will proportionally reduce the stop-loss charge for participating DCEs so that aggregate stop-loss payouts across all DCEs will equal the aggregate stop-loss charge. This policy is concerning in that it can unfairly reduce a DCE’s stop-loss payout as a result of the performance of other DCEs. The Innovation Center is currently reevaluating this policy and considering alternatives that do not use the national comparison. DCEs choosing to participate in the stop-loss arrangement must make the election by May 28.

BIDEN ADMINISTRATION SEEKS FEEDBACK ON ELIMINATING HEALTH DISPARITIES
On May 5, the Office of Management and Budget (OMB) released a Request for information (RFI) titled, Methods and Leading Practices for Advancing Equity and Support for Underserved Communities Through Government. This RFI seeks feedback from stakeholders on effective methods for assessing whether agency policies and actions equitably serve all eligible individuals and communities, with an explicit emphasis on historically-underserved populations. OMB will use the information received to expand the use of equity-assessment methods and approaches across the federal government. Agencies will be required to develop Equity Action Plans to outline the steps they will take to address identified inequities. OMB seeks input on five areas: (1) equity assessment strategies, (2) barrier and burden reduction, (3) procurement and contracting, (4) financial assistance, and (5) stakeholder and community engagement. Responses are due July 6 to [email protected].

Welcome New ACO Member

 Mercy Health ACO, LLC
 Chesterfield, MO

INSTITUTE PUBLISHES MEDICARE SPENDING TRENDS DURING COVID PANDEMIC
National Medicare spending per-beneficiary declined by 6.6 percent in 2020. There was substantial geographic variation in the rate of growth in Medicare spending per beneficiary due to local differences in the COVID pandemic and policies restricting business activity. The decline in health care utilization will affect future ACO benchmarks and annual update factors. The Institute for Accountable Care calculated the annual per-capita change in 2020 spending for ACO assignable Medicare beneficiaries (N=25 million) in 998 cities. Per-capita spending is annualized, truncated, and adjusted to remove COVID-19 spending according to MSSP program rules. The Institute has published a trend rate lookup tool.

ASSESS YOUR HIGH-VALUE CULTURE
The Institute for Accountable Care is currently working with the Kaiser Permanente Washington Health Research Institute and the ABIM Foundation to pilot a short survey that evaluates high-value care attributes within ACOs. This three-to-five minute web-based survey is sent to clinical staff, e.g., physicians, nurse practitioners, and registered nurses. We are seeking ACOs who would like to try this tool. We will provide the infrastructure for the survey and provide you with the option to add custom questions you might be interested in adding. ACOs can get access to their own data, obtain comparative results from other participating ACOs and participate in a free, one-hour webinar on how to support clinical value champions in your organization, hosted by Dr. Michael Parchman from the MacColl Center for Health Care Innovation at Kaiser Permanente. Participating ACOs will need to provide either an email list of clinicians who should receive a link to the survey or distribute the survey web link internally. If interested, please reach out to Jennifer Perloff or Leslie Valera.