REGISTER NOW FOR TODAY’S ANNUAL MEETING OF MEMBERS Join us today from 2:00 to 3:00 pm ET to hear from NAACOS leaders and to share your ideas for enhancing NAACOS products and services for members. The formal agenda will provide updates on our members, critical policy issues for ACOs, our advocacy efforts, the association’s finances, and the newly released BCAPA tool. The meeting is for ACO and Direct Contracting Taskforce members only, and it will allow plenty of time for questions and comments from members. Register now!
NEW COMPLIANCE TOOLS FOR MSSP, NEXT GEN AND DIRECT CONTRACTING 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 Direct Contracting Entity (DCE) Compliance Manual. You’re not going to want to miss this. Register today!
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 Don Berwick, Mark McClellan, and Rick Gilfillan.
Watch our Q&A with CMS officials, John Pilotte and Amy Bassano.
Get the latest updates to CMMI programs like Direct Contracting, the CHART Model, and Next Gen ACO Model.
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.
CATCH NAACOS WEBINAR SERIES ON DIRECT CONTRACTING Slides and recordings for the first two of NAACOS’s webinars on Direct Contracting’s financial details are now available. The webinars cover the implications for and perspective of Standard and New Entrant Direct Contracting Entities (DCEs). The webinars discuss risk adjustment and benchmarking, including use of the new Direct Contracting Rate Book. Registration is still open for the October 29 webinar covering High Needs Population DCEs. Participation is free for NAACOS ACO and Direct Contracting Taskforce members.
TELL YOUR ELECTED REPRESENTATIVES TO PRESERVE ADVANCED APM BONUSES NAACOS is working hard to have Congress address rising Qualifying Alternative Payment Model (APM) Participant (QP) Thresholds to achieve Advanced APM participation bonuses in 2021. But we need your help. Write your members of Congress and ask them to stop the thresholds’ unrealistic jump to higher levels in 2021. The jump threatens to derail our health industry’s move to support value-based payment. Visit our Take Action page to view a letter we’ve drafted to get you started.
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.
CQMC FINALIZES NEW ACO/PCMH QUALITY MEASURE LIST The Core Quality Measures Collaborative (CQMC) aims to align quality measurement efforts across payers. This group recently announced an updated ACO/PCMH measure set that the CQMC spent the past year deliberating. NAACOS board member, Dr. Rob Fields, serves on this group and was critical to providing ACO input throughout this process. Notably, the new measure set, which is voluntary for payers to adopt in their value-based contracts, includes several new measures such as those focused on screening for unhealthy alcohol use, asthma, and avoiding antibiotics for bronchitis. The new measure set is available on the CQMC website.
NOVEMBER 10 DEADLINE TO REQUEST 5 PERCENT ADVANCED APM BONUS On September 28, CMS published an updated list of unpaid QPs. These clinicians were not provided payment for the 5 percent Advanced APM bonus due to insufficient banking information. This could include certain physician assistants (PAs). ACOs should encourage practices to check the list to ensure providers listed request their payments from CMS by the November 10 deadline. CMS instructs providers to complete the necessary banking forms and submit them to the Quality Payment Program (QPP) Help Desk at QualityPaymentProgramAPMHelpdesk@cms.hhs.gov, no later than November 10, 2020.
NAACOS CALL FOR VOLUNTEERS NOW OPEN THROUGH NOVEMBER 6 We offer our members many opportunities to get involved in NAACOS, including speaking at our conferences and webinars and serving on committees. We need individuals with expertise in all subject areas, MSSP tracks and Next Gen ACOs. Some of the opportunities include speaking at a NAACOS conference or webinar; serving on the policy, quality, data or conference planning committees; grassroots advocacy efforts and hosting discussions on the NAACOS listserv.
If you are interested in volunteering, please sign up. In addition to standard contact information and information about your ACO, you will be asked to include a short paragraph describing your interests and expertise (500 characters) and your bio. Only NAACOS ACO members can volunteer and completing the application does not guarantee that you will be asked to serve. All volunteers are given the opportunity to decline specific roles without prejudice.
QPP PARTICIPATION STATUS TOOL NOW INCLUDES SECOND SNAPSHOT OF 2020 CMS recently updated the QPP Participation Status Tool based on the second snapshot of data (dates of service between January 1, 2020, and June 30, 2020) from APM entities. To view QP status, visit the QPP tool and search at the individual National Provider Identifier (NPI) level or view at the Tax Identification Number (TIN) level. Should you have any questions or concerns with the data provided, CMS instructs to contact the QPP Help Desk at QPP@cms.hhs.gov.
CMS MAKES FURTHER ADDITIONS TO TELEHEALTH FOR COVID-19 PHE On October 14, CMS added 11 new services to the list of those eligible to be delivered via telehealth list through this sub-regulatory guidance. These new telehealth services include certain neurostimulator analysis and programming services, and cardiac and pulmonary rehabilitation services. In the proposed 2021 Medicare Physician Fee Schedule, CMS proposed to permanently add nine codes to the list of those eligible to be delivered via telehealth and temporarily add another 13 codes on the list through the calendar year for which the COVID-19 Public Health Emergency (PHE) ends so that more evidence can be collected on their use. For more information on telehealth’s use during the public health emergency, visit this NAACOS resource. Be sure to view our Policy Principles for broader telehealth coverage as well.
IMPORTANT DEADLINES APPROACHING FOR DIRECT CONTRACTING’S PY1 Final Participant and Preferred Provider lists for Direct Contracting’s Performance Year 1 (PY1) are due October 23. DCEs can make changes in the 4i system. Also, DCEs accepted into PY1 have until October 30 to confirm their intention to participate in the model, although that indication is non-binding, CMS states. Those indications can be sent to the Direct Contracting helpdesk. Check out NAACOS’s resources on Direct Contracting.
CONGRESS PREPARES FOR ELECTION AND LAME DUCK The Senate is expected to vote Monday, October 26, to confirm Judge Amy Coney Barrett to the U.S. Supreme Court. Negotiations on a COVID-19 relief package are also ongoing with Congressional leaders and White House officials trying to secure a bipartisan agreement before the November election. Lawmakers are also beginning to line up priorities for an end-of-year lame duck session of Congress. While the lame duck agenda will be determined by the outcome of the election, House and Senate committee leaders are working to find a path forward on a Fiscal Year 2021 spending package that would also likely include expiring Medicare and Medicaid programs.
HOW THE LEGAL CHALLENGE TO THE ACA COULD AFFECT ACOS The U.S. Supreme Court is scheduled to hear oral arguments on Texas v. Azar, a case challenging the constitutionality of the Affordable Care Act (ACA) on November 10. Plaintiffs argue that the entire law is unconstitutional because the individual mandate provisions are not severable from the rest of the ACA. A federal district court has already ruled that the entire law is unconstitutional, and an appellate court upheld that decision, although the appeals court also asked that the district court again review the severability issue. The U.S. Supreme Court is expected to issue a final ruling in the Spring of 2021. Because both the Medicare Shared Savings Program (MSSP) and the Center for Medicare and Medicaid Innovation (Innovation Center) were created by the ACA, NAACOS continues to follow this case closely and has drafted an issue brief for ACOs to better understand various scenarios for how this case and its aftermath could play out.
NEXT GEN’S THIRD FORMAL EVALUATION PUBLISHED A formal evaluation of the Next Generation (Next Gen) ACO Model found participants generated a net reduction in gross spending for the third consecutive year in 2018, but increased net spending by $118 million after accounting for shared savings and $25 beneficiary rewards for receiving an annual wellness visit. Importantly, quality of care remained steady. The evaluation admits that lack of net savings was partly because of spillover of care from Next Gen providers to the comparison group, which included MSSP ACOs, and Next Gen’s baseline spending already being low because of efficiencies achieved under prior ACO participation. Savings were generated by reducing spending on professional services and post-acute care, but not through acute hospital stays. In 2018, the model’s third year, there were 50 ACOs participating. While NAACOS is disappointed this formal evaluation didn’t reflect net savings, we are hopeful the 2019 performance results will show continued positive results.
CMS ANNOUNCES NEW REPAYMENT TERMS FOR PROVIDER LOANS CMS recently announced new terms for repayment of loans issued under the Accelerated and Advanced Payment (AAP) Program. Repayment will now begin one year from the issuance date of each provider or supplier’s accelerated or advanced payment. Payment was previously required starting in August of this year. The Administration issued $106 billion in payments to providers to assist with financial burdens in the early stages of the COVID-19 PHE. More information is posted on the CMS website.
CMS SURVEY OUTLINES COVID’S IMPACT ON PATIENT CARE A survey of more than 11,000 Medicare beneficiaries this summer found 21 percent reported needing health care for something other than COVID-19, but not getting it because of the pandemic. Of that forgone care, 36 percent was a regular check-up or treatment for an ongoing condition and 32 percent was a diagnostic or medical screening. Sixty percent of beneficiaries reported that their provider currently offers telephone or video appointments. Survey results are available.
FRAMEWORK OUTLINES HOW TO ADVANCE APMS DURING COVID-19 PHE The Health Care Payment Learning and Action Network, a public-private partnership committed to ensuring the adoption of APMs, recently released a framework of short- and long-term actions the health system could undertake to be more responsive and resilient to events such as the COVID-19 pandemic. Actions include working with payers to more widely adopt alternative payment models, addressing racial and ethnic inequalities, and advance clinically integrated care. The full Healthcare Resiliency Framework is available.
