ASK LAWMAKERS TO EXTEND THE 5 PERCENT APM INCENTIVE PAYMENT
While NAACOS continues to hear from congressional staff that an extension of the 5 advanced APM (Alternative Payment Model) incentive is on Congress’ end-of-year agenda, there is a long list of health-related
priorities that need to be addressed this year. Accordingly, we must continue to make our voices heard by contacting lawmakers. Please use the resources available at the
Alliance for Value-Based Patient Care to contact your lawmaker and ask that they extend the advanced APM incentive payments. If you need support in
reaching out to the health staff in your lawmaker’s office, contact Robert Daley.
Welcome New ACO Member
Health Leaders Baton Rouge, LA
PARTICIPATE IN NAACOS POLICY WORKGROUPS
NAACOS is convening time-limited workgroups to develop recommendations on several key policies areas. Please review and let us know if you or someone from your team would like to participate in the workgroup.
We are looking forward to hearing from our members on these critical topics.
The Specialist Engagement in ACOs Workgroup will develop policy recommendations in response to CMMI strategy to support person-centered, value-based specialty care. Contact
Jennifer Gasperini to participate.
The Benchmarks Workgroup will develop solutions to benchmark challenges, including accounting for regional variation in spending, how to set fair risk adjustment policy, and the pathway to
administrative benchmarks. Contact David Pittman to participate.
The Patient Engagement Workgroup will seek to understand how ACOs are engaging patients and their ACO patient board representatives, sharing best practices, and leveraging this information for ACO
advocacy. Contact Alyssa Neumann to participate.
NAACOS COMMENTS TO CMS ON PROVIDER NATIONAL DIRECTORY
NAACOS is responding to a request for information
(RFI) issued by CMS on the development
of the first national directory of health care providers and services (NDH). Currently, health care directories are fragmented and non-standardized, leading to burdensome reporting requirements for providers
and inaccurate or out-of-date information for patients. NAACOS’ draft comments encourage CMS to ensure that an NDH
supports value-based care models by including information on providers’ APM participation and specialty designations for non-physician practitioners.
Comments are due December 6. If
you have additional input to our draft comments, email advocacy@naacos.com.
CONGRESSIONAL UPDATES
CONGRESS RETURNS FOR FINAL YEAR-END SPRINT
Lawmakers have until December 16 to reach an agreement to extend government funding. While negotiations on an omnibus budget bill have been slow, leaders are expected to continue working towards an agreement
over the next few weeks. A one or two-week short-term extension of funding is possible to give lawmakers additional time to address the larger budget and Medicare payment issues before the end of the year.
SENATORS SEEK TO IMPROVE CARE FOR DUAL ELIGIBLE BENEFICIARIES
Senators Bill Cassidy (R-LA), Mark Warner (D-VA), Tim Scott (R-SC), Tom Carper (D-DE), John Cornyn (R-TX), and Bob Menendez (D-NJ) are
seeking feedback from health care stakeholders
on ways to improve coverage for individuals with both Medicare and Medicaid. Their request seeks information regarding shortfalls in the current system of care, how to improve patient health outcomes, and the
role of federal or state governments in dual eligibles’ care. NAACOS would like to provide high-level feedback emphasizing value-based care as a solution to the cost and quality challenges when caring for
dual eligible beneficiaries. NAACOS members are welcome to provide our policy team with feedback by emailing us at
advocacy@naacos.com. We encourage members to share recommendations with us by December 23.
ADMINISTRATIVE UPDATES
DIRECT CONTRACTING GENERATED SAVINGS TO MEDICARE IN 2021
Participants in the Global and Professional Direct Contracting Model generated $117 million in gross savings and $70 million in net savings after accounting for shared savings, shared losses, and discounts,
according to data published by CMS last week
. About three quarters of DCEs generated savings while about a quarter generated loses. The final gross and net savings rates are in line with what we’ve seen in other ACO models, which should dispel any
notion that model participants stint patient care to generate massive savings for themselves. Fifty-three DCEs participated in the program in 2021, the model’s first year, caring for 357,000 patients. NAACOS
is working on a deeper analysis of the data. Congratulations to the participants on their performance!
CMS RELEASES PROPOSED RULE REGARDING SUBSTANCE USE RECORDS
The Department of Health and Human Services (HHS) published a proposed rule to align the regulation of privacy rules regarding patients’ addiction and substance use disorder treatment records with that of
Health Insurance Portability and Accountability Act of 1996 (HIPAA). NAACOS has long supported aligning the two, and Congress finally made the change in March 2020. NAACOS is still reviewing the rule and
plans to submit comments. We hope the proposal gets us closer to granting ACOs access to these records for better care coordination. The
press release and
fact sheet are available on the HHS website.
CMS CLARIFIES BENEFICIARY NOTIFICATION POLICIES FOR PY 2023
CMS has clarified that recently finalized changes to the Medicare Shared Savings Program (MSSP) beneficiary notification requirement are not retroactive. For ACOs continuing an existing agreement in
Performance Year (PY) 2023, only new beneficiaries that have not yet received the notice during your current agreement must be provided the standard notice and follow-up communication. CMS does not expect
ACOs to re-notify or follow up with beneficiaries who were provided the notice in PY 2022. More information on these changes can be found in
NAACOS analysis of the final 2023 Medicare Physician Fee Schedule (MPFS) rule. You can
contact advocacy@naacos.com with additional questions.
CHECK MIPS ELIGIBILITY, UPDATED BENCHMARKS FOR 2023
You can now check initial 2023 Merit-Based Incentive Payment System (MIPS) eligibility status on the Quality Payment Program (QPP) Participation Status Tool. CMS will update the tool at a later date; however,
initial eligibility information is now available by logging in to the QPP portal. Additionally, CMS recently posted a new
APM Performance Pathway (APP) Guide containing updated quality measure benchmarks
starting on page 19.
EDUCATION OPPORTUNITIES
LIMITED SEATS REMAIN FOR THE WINTER 2023 BOOT CAMP
Join us at the Marriott Orlando Airport Lakeside, February 9–10, 2023 for the Winter Boot Camp. The boot camp will provide
expert insight into the core competencies for ACOs. Faculty from top-performing ACOs, including Baylor Scott & White, Geisinger Health, Trinity Health, ChristianaCare, and NOMS, will present clinical and
operational strategies for success in any value-based care model. Participants will learn about clinical improvement models, their outcomes, and implementation tips and tricks. The format will include
presentations by clinical and operational leaders in accountable care, along with case studies, and peer-to-peer learning.
Boot camp topics and speakers have been announced and the full agenda will be announced this month.
**This boot camp will only be offered for in person. There will be no virtual option. Boot camps are not open to business partners. Space is limited to 100 people.**
REGISTRATION NOW OPEN FOR SPRING 2023 CONFERENCE
Join us May 3–5, 2023, for the NAACOS Spring Conference at the Hilton Baltimore Inner Harbor. This two-day, in-person event with pre-conference activities will feature the insights of CMS officials, ACO
leaders, and policy insiders, and also provide networking opportunities for participants, speakers, and vendors. Virtual and in-person registration options are available and, as always, the entire conference
will be recorded. Register early and save! Register before March 17 for the in-person or virtual conference and receive a discount.
Exhibitor and sponsor opportunities are now available! The conference will feature exhibitors with products and services specifically for the accountable care community.
Partners reserve your space today!
MSSP 3-DAY SNF WAIVERS: COMPLIANCE AND OPERATIONAL ISSUES
Register for our upcoming webinar on December 13 from 3:00 to 4:00 pm ET. Katie Carr, Mass General Brigham, and Ronda Winans and Leslie Cribbs, Trinity Health, will present their experience in MSSP ACO SNF
3-day waiver management, including creating a SNF network, completing and implementing compliance tasks, workflows and managing beneficiaries throughout the process. Katie Carr will provide Mass General
Brigham’s experience utilizing the ACO SNF 3-Day Waiver under multiple ACO models focusing on how their plan was implemented at a large health system. Ronda Winans will present her work in network development
and maintenance, and Leslie will present Trinity’s work in patient management processes. Register today!
CLINICAL AFFINITY GROUP MEETS TODAYAT 3 PM ET
New participants can still register for the Clinical Affinity Group virtual meeting today at 3:00 pm ET. We recently completed the Executive, Operations, Quality, and Data and Analytics Affinity Group
meetings for 2022 and had some great conversations. Don’t miss your opportunity to join today’s clinical care focused virtual meeting that provide peers in charge of patient care redesign in value-based care
with a forum to meet and discuss hot topics, exchange ideas, and participate in peer-to-peer exchange. These meetings are offered virtually between conferences for members only and in-person at our spring and
fall conferences for all conference ACO attendees. You can
sign-up for any of the virtual groups and receive information for upcoming virtual meetings.
Use the link below to join the Clinical/CMO meeting today. Once you sign up, the meeting link will work for future meetings for that group. Please make sure to add the appointments to your calendars.
VIRTUAL MEDICAID LEARNING LAB STARTS TOMORROW AND NOW OFFER CEU Register now to join the Learning Lab series on Medicaid contracting and patient management.
The virtual meetings in this series begin December 2 from 2:00 pm to 3:30 pm ET and will continue in monthly 90-minute sessions over the next 12-to-15 months. The Learning Lab will provide content on
value-based care models to support your contracted populations and networks, various Medicaid models throughout the states, workflow options for value-based care related to primary care, social determinants
of health, behavioral health, and high needs people, plus how to improve quality in the Medicaid population and how to enhance patient engagement in the Medicaid population. This series will offer a platform
to not only gain knowledge from on these topics but also create a strategic plan for implementation within your ACO. Our first virtual session on December 2 will feature Chad Boult, MD, MPH, MBA, creator of
the “Guided Care Model.” We are now offering CEUs for this and other Learning Labs for those who attend at least 75 percent of meetings.
Sign up today to learn about patient management and contract needs for Medicaid populations
and beyond.
HEALTHIER PATIENTS AND BOTTOM LINE: A REAL JOURNEY TO VALUE Webinar Sponsored by Oracle Cerner
Between the pressures of escalating costs, an aging population, health care delivery disruption and increased regulatory demands, many are feeling the weight of an unsustainable health care system. So how are
you juggling today’s health care demands? One health system turned to value-based care strategies. Join Hackensack Meridian Health (HMH), the largest health system In New Jersey, as they discuss their choice
to transform their health care delivery. Patrick Young, president of population health at HMH, will discuss their ongoing value-based care journey, how they are connecting their health care ecosystem,
value-based care strategies that have improved health care for their population and enhanced financial sustainability, and essential components to diversify from fee-for-service to a value-based delivery
model. Register today and join us on December 6, 2:00–3:00 pm ET. This webinar is open to NAACOS ACO members.
WHAT WE’RE WATCHING: NEWS ABOUT ACOS AND HEALTH CARE
The formal evaluation of the Next Generation ACO Model showed the program reduced gross Medicare
spending but increased net spending in 2020. ACOs were able to adapt to the COVID-19 Public Health Emergency well despite the pandemic’s many challenges.
The CMS Innovation Center published its formal evaluation of the Value-Based Insurance Design (VBID)
Model, showing innovative benefit designs were associated with reductions in plan bids but increases in premiums.
In Health Affairs Forefront, HHS examines the role of
community care hubs, as tested through the CMS Innovation Center’s Accountable Health Communities (AHC) Model, in
supporting the department’s strategic approach to addressing social
determinants of health. These hubs provide critical infrastructure to support sustainable partnerships between community-based organizations, health care providers, and the public health system.
