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Newsletter
for Members
and Partners |
| September
22, 2022 |
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LAST
DAY TO SIGN LETTER ASKING CONGRESS TO EXTEND APM INCENTIVES
NAACOS and
other leading national health care associations are organizing a sign-on letter asking
Congress to extend the 5 percent Advanced Alternative Payment Model (APM) incentive
payment. The deadline to sign on is COB Friday, September 23.
We are hearing from congressional staff that an extension of the Advanced APM incentive
payment is under consideration. This letter is an important step in signaling to
lawmakers that an extension is critical. We have over 400 signatures and need more to
urge lawmakers to act before the end of the year. We are collecting signatures from
ACOs, DCEs, health systems, and individual physician practices. For ACOs with multiple
physician practices, we encourage you to extend the sign-on opportunity to them. For
ease, we can receive your physician practice signatures outside of the signature form.
Contact Robert
Daley for more information.
MARK
YOUR CALENDAR: NAACOS TO CO-HOST CONGRESSIONAL BRIEFING
NAACOS,
America’s Physician Groups (APG), Premier, and other ACO stakeholders are hosting a Capitol Hill briefing on Thursday, September
29. The briefing will highlight the benefits of value-based care and call
on Congress to extend the 5 percent Advanced APM incentive payment. We are also
encouraging our members to share this opportunity with your contacts on Capitol Hill.
MSSP
GENERATED $3.6 BILLION IN SAVINGS IN 2021
NAACOS is pleased to see MSSP
ACOs record another successful year. In 2021, ACOs collectively saved Medicare $3.6
billion and $1.6 billion after accounting for shared savings payments. Of the 475 ACOs,
who served more than 11 million beneficiaries, 81 percent generated savings and 56
percent generated enough to earn shared savings. This translates to $357 in gross
savings per beneficiary. We issued a press release to tout these results.
NAACOS
congratulates ACOs on their great work in 2021, especially given challenges facing the
pandemic, and we encourage members to share 2021 performance results with internal and
external audiences, including the press. We developed a media kit to get you
started. It’s important to share the results of your hard work and demonstrate the
benefits of care coordination and accountable care. Please send your published releases
to [email protected],
and we’ll publish them on the NAACOS Member News page.
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Welcome
New Business Partners
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Alera
Group
Alera
Group is an independent, national insurance and financial services
firm created through the merger of like-minded, high-performing,
entrepreneurial companies across the United States.
aleragroup.com |
Medisolv
Medisolv
is on a mission to improve the quality of patient care and provider
performance 365 days of the year using the latest technologies
paired with the irreplaceable asset of human touch.
medisolv.com/ |
Connective
Health
On
behalf of the Primary Care Provider, Connective Health facilitates
the connection to a variety of clinical data networks to locate
records, makes the data meaningful, and delivers summarized details
into the PCP’s workflow to support effective coordination of care
and improved patient outcomes.
connectivehealth.io |
Novartis
Pharmaceuticals Corp
Novartis
is reimagining medicine to improve and extend people’s lives. We are
working hard to produce breakthroughs and address unmet needs for
patients with devastating diseases, including genetic disorders and
certain deadly cancers. We also are committed to ensuring our
medicines reach as many people as possible.
novartis.us |
InteropX
InteropX
Data Bridge provides an automated and cost-effective clinical data
exchange solution for MSAs/ACOs to produce the desired outcomes for
Risk Adjustment and Quality Care Gap closure while decreasing
practice IT burden and physician abrasion.
interopx.com |
Videra
Health
Videra
Health is an FDA-registered digital health platform, and the leader
in video-based assessments, screenings, and check-ins. We close the
care gap by connecting with patients and members outside of live
visits, and allow them to share what they want, when they want, in a
way they like to communicate: video.
viderahealth.com
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ICYMI:
NAACOS SUBMITTED COMMENTS
Over the past several weeks, NAACOS provided
input to CMS on the MSSP proposed rule and Medicare Advantage (MA) request for
information (RFI). Read our comments below:
NEARING
DEADLINES DRIVE CONGRESSIONAL AGENDA
This week Congress is focused on
negotiating a short-term continuing resolution (CR) to fund the federal government after
September 30, when the current funding expires. The expectation is that the CR will
provide funding through December 16, allowing congressional members to travel home for
much of October to campaign in advance of the mid-term elections. Congress is also
negotiating a reauthorization of the U.S. Food & Drug Administration (FDA) user fees
legislation, another must-do item before September concludes. The White House recently
released a list of priority items for the CR, including policies facing statutory
expiration. The list included extension of the advanced APM incentive payments.
Also hanging in the balance is a White House request to add $47 billion in emergency funding
for monkeypox, COVID-19, natural disaster relief, and the Ukraine war to the CR,
although these items are unlikely to receive the requisite support to be included.
Growing uncertainty regarding the expiration of the COVID-19 public health emergency
(PHE), and potential legislative fixes to permanently extend the PHE waivers, in
addition to the expiration of the 5 percent Advanced APM incentive payment and the “doc
fix,” also are in play for resolution in an end-of-year package. NAACOS continues to
advocate for an extension of the Advanced APM incentive payment to be included in a
year-end bill.
LAWMAKERS
REQUEST INPUT ON STRENGTHENING MACRA
A group of eight House lawmakers
released a request for public comment on actions Congress can take to
stabilize the Medicare payment system and improve the Medicare Access and CHIP
Reauthorization Act (MACRA). NAACOS will be submitting comments to advocate for an
extension of the 5 percent Advanced APM incentive payment, along with providing
longer-term policy recommendations to improve MACRA. NAACOS members are welcome to
provide our policy team with feedback by emailing us at [email protected].
We encourage members to share recommendations with us by Wednesday, October 12.
REPRESENTATIVE
DELBENE WRITES OP-ED PROMOTING ACOS
Rep. Suzan DelBene (D-WA) wrote an op-ed in Modern Healthcare promoting
value-based care on September 19. The Congresswoman has been a leading supporter of ACOs
and discusses how shifting from volume to value helps drive better outcomes and
strengthen Medicare. The op-ed highlights the success of value-based care, ongoing
challenges with growth, and calls on Congress to support policies to expand
participation in ACOs. Most importantly, it calls on Congress to extend the 5 percent
Advanced APM incentive payment that will expire at the end of this year. NAACOS
appreciates the Congresswoman’s support and looks forward to working with her and other
members of Congress to strengthen ACOs.
LAWMAKERS
INTRODUCE BILL TO STOP PHYSICIAN PAYMENT CUTS
Reps. Ami Bera (D-CA) and
Larry Bucshon (R-IN) also introduced legislation that would address physician payment
cuts by temporarily increasing the Medicare conversion factor. The legislation also
includes a non-binding recommendation that Congress and the Administration work together
to ensure a stable Medicare payment system that rewards value-based care and advances
health equity.
HOUSE
PASSES LEGISLATION TO REFORM MA PRIOR AUTHORIZATION
On September 14,
the House unanimously passed a bill to establish electronic prior authorization process
for MA, increase data transparency, and establish real-time approvals for certain
benefits. The bill has broad bipartisan support from Members of Congress and stakeholder
groups. The bill now moves to the Senate where it could be included in an end-of-year
legislative package.
CONGRESSIONAL
PROGRESSIVES CONTINUE TO CALL FOR REACH TERMINATION
In a recent letter
responding to a request for reforms to the MA program, 31 progressive Democrats called
on CMS to cancel the ACO REACH model, expressing concern over patient protections and
the effects on Medicare spending. The press release and full letter are online. NAACOS continues to monitor these calls
and educate progressive members on the benefits of ACOs.
CMS
TO SHARE MORE DATA ON CMMI MODELS
Following NAACOS advocacy, the Center
for Medicare and Medicaid Innovation (CMMI) announced it would make more participation
data available to researchers. The data includes Global and Professional Direct
Contracting as well as other CMMI models. Data on participating providers and attributed
beneficiaries will allow researchers the opportunity to conduct more rigorous analysis
of models and provide more learning opportunities for model participants.
RADIATION
ONCOLOGY MODEL FORMALLY DELAYED
As expected, CMS finalized its decision to indefinitely delay the Radiation
Oncology Model. The mandatory model aimed to test prospective, episode-based payments
for 90 days of radiation therapy treatment used to treat one of 16 cancer types. The
model been strongly opposed by the oncology provider community.
CMMI
PUBLISHES QUALITY PAPER AND PERFORMANCE RESULTS FOR REACH/DC
Participants in ACO REACH next year should make themselves aware of the paper outlining the model’s quality methodology, which was
recently published. It deviates little from what we’ve seen in Global and Professional
Direct Contracting aside from the reduction in the quality withhold.
CMMI
also recently published program-wide performance results for 2021. The 53 DCEs cared for
344,000 beneficiaries and collectively produced 1.7 percent savings compared to their
benchmarks. These savings are on top of the 2 percent discount for Global DCEs. NAACOS
anticipates CMMI to soon release individual-level DCE results. More information on 2021 results is available.
CMS
POSTS 2022 WI BENCHMARKS
CMS recently posted 2022 Web Interface quality benchmarks on the Quality Payment
Program (QPP) website. Benchmarks are included in the appendix and listed for each
percentile, starting with the 30th percentile and ending with the 90th percentile. For
Performance Year (PY) 2022, MSSP ACOs can report via Web Interface (WI), electronic
clinical quality measures (eCQMs) or Merit-based Incentive Payment System (MIPS) CQMs.
Measure specifications and benchmarks differ based on the reporting method chosen.
Quality benchmarks for eCQMs and MIPS CQMs are available in the QPP resource
library.
CMS
SEEKS FEEDBACK ON EQUITY AND BURDEN REDUCTION
CMS recently released an RFI to seek broad public input on
accessing health care and related challenges, understanding provider experiences,
advancing health equity, and assessing the impact of waivers and flexibilities provided
in response to the COVID-19 PHE. NAACOS will be submitting comments highlighting the
role of ACOs in ensuring access to high-quality care and advancing health equity. We
encourage members to share feedback on these topics with our policy team by emailing [email protected].
Responses must be submitted through the public comment portal by November 4.
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Welcome
New ACO Members
Health
Partners for the Elderly
Land
O Lakes, FL
Valley
Health
Winchester,
VA
Appalachian
Health Network
Lexington,
KY
Welcome
New Associate ACO Member
Wellvana
Nashville,
TN
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UPCOMING
SPONSORED WEBINAR
LabCorp will host a webinar on October 5 from 2:00–3:
00 pm ET with speaker Linda Fraunhofer, LabCorp Population Health Initiatives, on
Advancing the Health of Underserved Populations: How a Lab Can Support Community Health
Initiatives. This webinar is free to all ACO members and non-members but is not open to
business partners or other vendors. Register Now!
Webinar
Description
Many health care organizations have a desire to
proactively identify and address health care inequities among their underserved and
vulnerable patient populations. Using population-level lab data, health systems are
positioned to improve patient outcomes and better meet value-based care goals. In this
webinar, attendees will learn how health systems can align with public health
organizations to identify and analyze areas of concern within their community; how
health systems can develop internal policies, care protocols and activities to better
support underserved populations in their community; and how lab data can support
community benchmarking and chronic disease surveillance, while guiding efforts to
improve community health.
PTAC
HOSTS PUBLIC MEETING ON TOTAL COST OF CARE MODELS
This week, the
Physician-Focused Payment Model Technical Advisory Committee (PTAC) hosted a public meeting to discuss financial incentives
and payment strategies for population-based total cost of care models. This meeting is
the third in a series of theme-based discussions around design and implementation
considerations for population-based total cost of care models. The Institute for
Accountable Care presented to PTAC on the alignment of specialist physicians with ACOs.
IAC also published an editorial on specialist alignment in the American Journal of
Accountable Care. NAACOS provided detailed feedback to the committee in response to an RFI issued
earlier this year and highlighted key points from the letter in public comments. Meeting
materials and a recording (when available) will be shared on PTAC’s website.
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