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Deadline Extended! Nominate Your Organization for an Excellence Award
The deadline to nominate your organization for a NAACOS Excellence Award has been extended to August 9. Don’t miss your chance to nominate your organization for a NAACOS Excellence Award. The NAACOS Excellence Awards recognize high-performing organizations that have demonstrated an outstanding commitment to and accomplishments in value-based care. Recipients of the award exemplify how value-based care can transform health care delivery by improving quality and outcomes, lowering or slowing growth of costs, and increasing patient and provider satisfaction. Submissions will need to demonstrate success in five key areas: (1) patient and community engagement, (2) commitment to a value culture across the organization, (3) a focus on outcomes, (4) use of data and tools, and (5) how clinical interventions are used to improve patient care.
Awardees will be notified in early September, and awards will be presented during the plenary session at the NAACOS Fall Conference October 17-18 at the Marriot Marquis in Washington, D.C. Awardees will also present as part of a panel discussion. Presenters will be given complimentary conference registration. Learn more about the award criteria and submission process on our website; submit your entry today! If you have any questions, email advocacy@naacos.com.
NAACOS Files Comments on Anomalous Billing Rule
NAACOS supported a proposed CMS rule that will remove two problematic catheter codes from MSSP financial calculations in 2023. Through both it’s own letter and a letter joined by 11 other national organizations, we urged CMS to quickly finalize its Significant, Anomalous, and Highly Suspect (SAHS) Billings rule. In NAACOS’ own letter, we encouraged CMS to also look at SAHS billing for ventilators, diabetic supplies, and collagen dressings and to extend participation deadlines by six weeks, like the delay in financial reconciliations.
In addition to reporting suspected fraud to the HHS Inspector General and your ACO liaisons, CMS is encouraging ACOst to send reports to CMS’s Center for Program Integrity at dpi.intake@cms.hhs.gov.
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Congress Breaks for August Recess
Lawmakers wrapped up work this week for the summer recess that extends through Labor Day. When lawmakers return in September, congressional leaders will need to rally support to pass an extension of government funding that will extend past the mid-term elections. Behind the scenes health committees will continue working on health care priorities, including physician payment reform and telehealth. These issues are expected to be on the agenda for the lame-duck session following this year’s elections.
MSSP Phase 1 RFI-1 Responses Due by Noon Eastern Today
ACOs applying to participate or submitting change requests for Performance Year (PY) 2025 in MSSP have until 12:00 pm ET today, August 1, 2024, to submit Phase 1 RFI-1 responses. This is the final opportunity to add ACO participants and/or SNF affiliates to your ACO, and it is the last opportunity to apply for the SNF 3-day rule waiver for PY 2025. Additional information on the application deadlines can be found on the Application Types & Timeline webpage and in the Application Reference Manual.
CMS has extended the deadline to submit the ACO Primary Care Flex (PC Flex) Model application questionnaire. ACOs applying for this option will have until 11:59 pm ET on August 23, 2024, to submit the questionnaire and be considered for model participation. Details on the PC Flex application questionnaire and on the PC Flex Model are available in the Request for Applications and on the model webpage. ACOs applying to participate in PC Flex remain subject to all MSSP application deadlines and requirements.
ACO REACH’s 2025 Changes Announced
The CMS Innovation Center announced several changes coming next year to the ACO REACH Model. These changes are spelled out in this fact sheet and include:
- Adjustments to the way financial spending targets or benchmarks are set for High Needs ACOs to better reflect the spending in their patients and reduce the benchmark “ratchet,”
- Updates to the way CMS defines health equity for the purposes of the model’s health equity benchmark adjustment,
- Exclusion of expenditures for two problematic catheter codes from the 2023 performance year, with guidance on how to handle anomalous billings in future years forthcoming,
- Several changes to the formation of ACO benchmarks to generate more savings for CMS,
- An increase to the discount (the proportion of an ACO’s benchmark that CMS keeps in savings) from 3.5 percent this year to 4 percent in 2025, and
- Inclusion of GUIDE Model payments as ACO expenditures in 2025.
Changes are influenced by the recently released 2022 formal evaluation, and attempts to create more savings for CMS. Additionally, there are some changes that are a direct result of NAACOS advocacy, including a correcting of the pending ratchet for high needs ACOs and a removal of the problematic catheter codes. We appreciate your feedback on potential model changes you’ve vocalized in recent months. NAACOS is digging into these changes and will have more to say; please share any feedback you have with advocacy@naacos.com
More Granular Patient Data Released to REACH ACOs
Recently, the CMS Innovation Center began sending REACH ACOs patient-level quality scores. This allows ACOs to better judge performance on the model’s claims-based quality measures, which has been a point of advocacy for NAACOS.
Updated AHEAD Model Financial Methodology Released
The CMS Innovation Center has revised and released the methodology for forming hospital global budgets under the States AHEAD Model, the new model that tests hospital global budgets and advanced primary care payments. The full specifications are here, along with webinar slides and FAQs. Maryland, Vermont, and Connecticut are the first states to participate in the model, with Hawaii’s participation pending. The multi-payer AHEAD Model runs through 2034.
FALL CONFERENCE EARLY REGISTRATION DEADLINE EXTENDED TO AUGUST 9!
The early registration deadline for the Fall 2024 Conference on October 16-18 at the Marriott Marquis in Washington D.C., has been extended for one week until Friday, August 9 at 5:00 pm ET. The full agenda is available on our website and features leading value-based care experts and CMS officials sharing timely and essential information for ACOs and other value-based care models, including Jon Blum, principal deputy administrator and chief operating officer at CMS, and author, Robbie Pearl.
Register before August 9 for the in-person conference and receive a discount of $300 per person. Can’t attend in person? Register for the live webcast before August 9 and receive a discount of $100 per person. We are offering group rates to NAACOS ACO members for both the in-person and virtual conference. The early registration deadline for group rates is also August 9. For more information, please contact Emily Perron.
Sponsor and exhibit opportunities for the Fall 2024 Conference are selling out! Partners interested in exhibiting or sponsoring should contact Emily Perron.
Attend the August 7 Member Forum on NAACOS Strategic Priorities
Register for the upcoming Member Forum on NAACOS Strategic Priorities. As the preeminent organization supporting coordinated, patient-centered, value-based care, NAACOS is committed to improving quality care for patients. Join us on August 7 at 2:00 pm ET to learn more about our vision for the future through thought leadership, education, and broadening our stakeholder base. Engage with NAACOS board members and staff to share your feedback and help shape the direction of upcoming learning, education, and membership initiatives.
Webinar on AI in Value-Based Care: The Hype, The Hope, and The Reality
Register today for the upcoming webinar sponsored by Innovaccer, AI in Value-Based Care: The Hype, The Hope, and The Reality. Learn more about how the reality of AI solutions lives up to the hype on August 22 at 2:00 pm ET.
Build your ACO’s Post-Acute Care Management Strategy
Does your ACO have an effective strategy to manage post-acute care spending? In a recent white paper, the Institute for Accountable Care (IAC) found wide variation in SNF spending and quality in most health care markets. ACOs can easily save $5,000 or more per case by shifting patients from inefficient to efficient skilled nursing facilities. IAC has built comprehensive reports to help ACOs evaluate the SNFs in their market to identify opportunities for savings and quality improvement. The The IAC SNF market dashboard five years of comprehensive data (2019-2023) for every SNF in your market, looking both at the SNF stay and the 30-day post-discharge period. Contact analytics@institute4ac.org learn more about accessing comprehensive post-acute care data for your market.
| WHAT WE’RE WATCHING: NEWS ABOUT ACOS AND HEALTH CARE |
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- The Department of Health and Human Services (HHS) recently announced a reorganization of the former Office of the National Coordinator for Health Information Technology (ONC), now the Assistant Secretary for Technology Policy/ONC. Read more about this transition in their recent blog post.
- The Commonwealth Fund probes why primary care providers aren’t joining APMs.
- The Medicare Payment Advisory Commission (MedPAC) released its annual Data Book.
- CMMI Director Liz Fowler talks the future of specialty and primary care integration on Health Affairs’ podcast.
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