HHS EXTENDS COVID-19 PUBLIC HEALTH EMERGENCY HHS will renew the COVID-19 Public Health Emergency (PHE) effective October 23, when it is currently set to expire. Because PHEs are extended for 90-day periods, this will extend the PHE through late January 2021. Several protections and benefits are connected to the PHE, including mitigation of ACOs’ shared losses, removing certain expenditures for COVID-infected patients, and allowing greater use of telehealth. For more information on COVID-19 and ACOs, visit NAACOS’s dedicated COVID-19 page.
ACTION ALERT: URGE MEMBERS OF CONGRESS TO ADDRESS RISING QP THRESHOLDS NAACOS continues to urge its members to write their elected representatives and ask them to address rising Qualifying Alternative Payment Model (APM) Participant (QP) Thresholds to achieve Advanced APM participation bonuses in 2021. Right now, thresholds to secure incentive payments are set to increase to unrealistic levels in 2021, threatening to derail our health industry’s move to support value-based payment.
NAACOS WEBINARS ON NEW DIRECT CONTRACTING MODEL FINANCIAL DETAILS To help Direct Contracting Entities (DCEs) and ACOs understand the financial details of the Direct Contracting Model, NAACOS is hosting a series of webinars in October. The three webinars will cover the perspectives of Standard, New Entrant, and High-Need Population DCEs and will cover risk adjustment and benchmarking, including use of the new Direct Contracting Rate Book. Attendees will hear from policy and data experts as well as from newly forming DCEs. Participation is free for NAACOS ACO and Direct Contracting Taskforce members. Register today!
COMPLIANCE TOOLS FOR MSSP, NEXT GEN AND DCE Just because there’s a pandemic doesn’t mean compliance can be ignored! Come join us on October 26th at 11:00 am ET to hear the latest news from compliance experts and how to keep your ACO’s programming on the right side of the law! We’ll discuss changes for your respective program and unveil the newest member to the compliance manual family: The DCE Compliance Manual. You’re not going to want to miss this. Register today!
NAACOS PRESENTS CHAMPION OF VALUE IN HEALTH CARE AWARDS NAACOS recognized four members of Congress for their leadership in advancing value-based payment, bestowing the inaugural NAACOS Champion of Value in Health Care Award. These lawmakers have been champions of ACOs and other value-based care models and the tools they need to be successful. The awards went to Reps. Suzan DelBene (D-WA), Darin LaHood (R-IL), Peter Welch (D-VT), and Roger Marshall, M.D. (R-KS). In addition to sponsoring the Value in Health Care Act, or Value Act for short, and the Accountable Care in Rural America Act, these leaders have been advocates for their constituent ACOs with CMS and the CMS Innovation Center, helping inform the agencies’ value-based care work.
MISSED THE FALL CONFERENCE? GET ACCESS TO ALL RECORDED CONTENT If you were unable to attend the recent virtual conference live, we are selling access to the archive of all sessions for $300 off of the cost of the standard rate of the conference.
Hear from ACO thought leaders like Don Berwick, Mark McClellan, and Rick Gilfillan.
Watch our Q&A with CMS officials, John Pilotte and Amy Bassano.
Learn successful strategies for managing risk, data sharing, Medicare Advantage, and more.
Use the code RecordingsOnly to gain access at the discounted rate. Soon after you register, you will receive a link and your log-in information to access the recordings, which will be available until April 1, 2020.
Welcome New ACO Members
Arkansas Rural Health Partnership Clinically Integrated Network, LLC Pine Bluff, AR
NAACOS UPDATES BENCHMARKING TOOL FOR MEMBERS To help MSSP ACO members get an accurate picture of their performance, our new Benchmarking Comparison and Performance Analysis (BCAPA) reporting tool allows you to compare your ACO’s performance to various peer groups on standardized Part A and Part B spending and utilization measures. As a member of NAACOS, ACOs receive access to their own data for free; reports with data from customized peer groups are also available for a fee. Available as a web-based tool, BCAPA users can navigate easily between report views and download report views to Excel with one click.
NAACOS Business Partners may now purchase access to ACO data! Business Partners can use this data to help their ACO clients achieve better care, better health, and smarter spending. This data can also identify potential clients that would benefit from a BP’s products and services. The BCAPA webpage has a recorded tutorial on the basics of using the new report; this webpage also has FAQs and explanations of the methods, source data, and definitions. For more information, contact data@naacos.com.
CALL FOR VOLUNTEERS NOW OPEN! NAACOS is soliciting volunteers from our ACO members who are interested in possibly serving on one of our committees (Policy, Quality, or Data) or serving NAACOS in another way such as speaking at a conference, assisting with grassroots advocacy, and others. Those interested need to complete the Call for Volunteers form before November 6. NAACOS Staff will then compile all of the information on the volunteers in November and the NAACOS board chair, along with the committee chairs, will select appropriate individuals to serve on the committees for 2021–2022. Individuals will be notified one way or the other, if volunteering to serve on committees. If you are interested in serving another way, NAACOS staff will be reviewing the information and contacting you at appropriate times. Please note, you may not hear back right away if we are not in current need of a speaker in your expertise area or if there is not currently an advocacy campaign happening. If you have any questions or have difficulty with the form, please contact Anna LaFayette.
COVID RELIEF DEBATE DELAYED AS SENATE FOCUSES ON SCOTUS NOMINATION After agreeing to extend government funding through December 11, Congress shifted attention back to stimulus negotiations and the U.S. Supreme Court. House Democrats passed an updated COVID-19 relief package last week that includes an additional $75 billion for testing, $50 billion in provider relief funds, and $20 billion for vaccines. On October 6, President Trump rejected the House proposal and postponed negotiations until after the election. The President is instead encouraging the Senate to focus on confirming Judge Amy Coney Barrett to the U.S. Supreme Court. While the Senate has delayed previously scheduled floor activity until October 19 after a number of Senators tested positive for COVID-19, Senate Republican leaders have said the delayed floor schedule would not affect the confirmation timeline. The Senate Judiciary Committee plans to begin confirmation hearings October 12.
LAWMAKERS BRING ATTENTION TO ACO ADVOCACY PRIORITIES As the COVID-19 pandemic continues to affect the health care system, Members of Congress are advocating for changes that will ensure the long-term success of ACOs and other value-based care organizations. On September 21, a bipartisan group of 29 lawmakers sent a letter to House leaders urging congressional action this year to modify the QP thresholds that will jump to unsustainable levels in 2021. On September 22, a bipartisan group of six lawmakers also sent a letter to CMS asking for more flexibility for ACOs in light of the COVID-19 pandemic. While CMS has already taken a number of steps to help mitigate financial losses ACOs and other APMs experience during the pandemic, NAACOS and the stakeholder community will continue working with Congress to ensure that appropriate policy changes are made to protect Medicare’s value-based care movement.
TRUMP ADMINISTRATION ANNOUNCES NEW PHASE 3 PROVIDER RELIEF FUNDING The Trump Administration recently announced $20 billion in new Phase Three Provider Relief Funding. Under this third phase of fund allocation, providers that have already received Provider Relief Fund payments will be invited to apply for additional funding that considers financial losses and changes in operating expenses caused by the COVID-19 pandemic. Providers are able to begin applying for funds starting October 5 through November 6. More information on eligibility criteria is available on the CMS website.
QPP REPORTS PROVIDED — CHECK FOR ACCURACY CMS recently updated the Quality Payment Program (QPP) website to include 2020 Alternative Payment Model (APM) incentive payment details. These provide information on eligible clinicians who were Qualifying APM Participants (QPs) based on their 2018 performance and began receiving their 2020 5 percent APM Incentive Payments this month. ACOs should check the portal information for accuracy and contact the QPP with any issues at QPP@cms.hhs.gov.
INNOVATION CENTER RESPONDS TO NAACOS ON UNILATERAL NEXT GEN CHANGE CMS responded to a recent letter NAACOS sent to the Innovation Center requesting the center not move forward with a unilateral change to the trend rate used for the model. While NAACOS supports providing protections from COVID-19 to Next Gen ACOs through an optional amendment, we are disappointed CMS is also implementing unilateral changes for ACOs that would prefer to maintain their agreed upon risk levels and prospective benchmarks for 2020. The Innovation Center’s response explains that COVID-19 has had a dramatic impact on 2020 expenditures, and if that renders the projected trend invalid the agency will adjust the trend for the model using an option previously available to the agency for this model.
CMS UPDATES MEDICARE COVID-19 SNAPSHOT The most recent data from CMS show there have now been more than 1 million COVID-19 cases among Medicare beneficiaries and more than 284,000 hospitalizations. Each hospitalization averaged just under $25,000 for a total of $4.4 billion. Nearly half of the hospitalizations lasted seven days or less while 5 percent lasted more than 31 days. The rate of COVID-19 cases among Medicare beneficiaries grew 30 percent since August to 1,562 cases per 100,000 beneficiaries, and the rate of COVID-19 hospitalizations among Medicare beneficiaries grew 32 percent since the August release to 444 hospitalizations per 100,000 beneficiaries. CMS has released monthly data on COVID-19 cases and hospitalizations among Medicare beneficiaries. The current data are based on Medicare Fee-for-Service claims and Medicare Advantage encounter data CMS received by September 11, 2020.
KEY DEADLINE FOR MSSP ACOS TRANSITIONING TO DIRECT CONTRACTING MODEL CMS is requiring ACOs to notify the Medicare Shared Savings Program no later than October 20th if an ACO is terminating its MSSP participation for Performance Year (PY) 2021 to participate in the Direct Contracting Model beginning April 2021. While MSSP ACOs are normally required to provide termination notice only 30 days or more in advance of the performance year ending, it is important for MSSP ACOs transitioning to the Direct Contracting Model to terminate by October 20 to allow the agency to properly conduct alignment for both models. Notification of termination after October 20th will prevent an MSSP ACO from participating in the Direct Contracting Model in PY 2021.
MEDPAC DISCUSSES APM ROLE IN MEDICARE’S FUTURE At its October meeting, the Medicare Payment Advisory Commission (MedPAC), a closely watch panel that makes recommendations on Medicare payment policy, discussed the future of APMs in Medicare. There was widespread agreement among commissioners that there are too many models being tested, which complicates how to evaluate the work of individual models and makes participation more complex for providers. Instead, several commissioners recommended that the Innovation Center focus on a limited set of models that have shown value and work well together. Commissioners had mixed opinions on the need to have mandatory models. A few mentioned the need to have better incentives for patients but didn’t mention specifics on how to do that. Slides from the meeting are posted online. The general topic of APMs is expected to be a multi-year project for MedPAC and several of the topics discussed will need deeper dives in future meetings.
CMS RELEASES INITIAL DATA ON ACCOUNTABLE HEALTH COMMUNITIES MODEL Food needs were the most commonly reported health-related social need among Medicare and Medicaid beneficiaries, followed by housing, transportation, and utility assistance. The data came from the CMS Innovation Center’s Accountable Health Communities Model, which tries to address the gaps between clinical care and community services by testing whether systematically identifying and addressing the health-related social needs of Medicare and Medicaid beneficiaries’ will impact health care costs and reduce health care utilization. Of the 750,000 screened, about a third reported at least one social need. Of those screened, 18 percent were eligible for community navigation services, and 76 percent of eligible beneficiaries accepted the navigation assistance. CMS recently released a fact sheet on the model’s initial data.
