NAACOS PARTICIPATES IN HEALTH CARE VALUE WEEK
This week, NAACOS co-hosted a panel discussion with the Primary Care Collaborative (PCC) as part of the
2023 Health Care Value Week virtual conference series. The session, titled “Patients and Primary Care Powering ACOs to Shared Success,”
was moderated by NAACOS’ SVP of Government Affairs Aisha Pittman and included speakers Bob Rauner from OneHealth Nebraska, Clive Fields from Village MD, and Sarah Coombs from the National
Partnership for Women & Families. You can still register to watch this session and others on-demand
through the virtual platform.
Welcome New ACO Members
Empassion Satellite Beach, FL
SBL Accountable Care Organization Mattoon, IL
Fast Pace Health Franklin, TN
CONGRESSIONAL UPDATES
CONGRESS PREPARES TO ADDRESS DEBT CEILING
The Treasury Department informed lawmakers last week that the country hit the debt limit. This means that the administration will need to undertake “extraordinary measures” that will allow the
government to continue processing payments to federal programs. This is expected to give lawmakers until June to address the spending limits. Congressional Republicans are calling on the White
House to support spending reductions as a condition to increase the debt ceiling. While the White House is asking lawmakers for a debt limit increase without conditions, the President is
expected to meet with Speaker Kevin McCarthy (R-CA) in the coming weeks. While large scale entitlement reforms are unlikely, there are some House Republicans calling for reforms to Medicare
and other entitlement programs. With the new Congress only weeks old, brinkmanship surrounding the debt ceiling is expected to intensify and consume much of lawmakers’ attention throughout the
first half of the year.
ADMINISTRATION UPDATES
CMS PUBLISHES ACO PARTICIPANTS FOR 2023
There are more patients than ever aligned to ACOs in 2023, according to new data released by CMS. There are 10.9 million patients assigned to MSSP ACOs, and 2.1 million assigned to ACO REACH
participants in 2023. While the number of MSSP ACOs fell this year to 456, there are 132 REACH ACOs, making up for the drop in MSSP participation. In our
press release we were pleased with the moderate growth in the program and noted
that we anticipate growth in MSSP ACOs next year due to recent changes in the program. However, it remains a priority for the administration to innovate within MSSP to encourage growth. For
example, nearly two-thirds of MSSP ACOs are in two-sided risk models, signaling a desire for experienced ACOs to take on risk. NAACOS is requesting CMS to create more high-risk options in
MSSP. More data on the MSSP and
ACO REACH classes, as well as the
CMS press release,
are available online.
UPDATED DIRECT CONTRACTING PERFORMANCE RESULTS RELEASED
The CMS Innovation Center released quality and financial performance results for the
Global and Professional Direct Contracting Model through September 2022. Overall, 99 direct contracting entities (DCEs) averaged a 2.0 percent reduction in Medicare spending compared to their
benchmarks through the first three quarters of 2022. This is analogous to a medical loss ratio of 97.78 percent. It’s also a better shared savings rate than Performance Year (PY) 2021. For
quality, DCEs showed an improvement in unplanned admissions for patients with multiple chronic conditions compared to non-DCEs, which include providers both in ACOs and not in ACOs. However,
DCEs’ all-condition readmission performance was not statistically significant compared to non-DCEs.
DETAILS ON MEDICARE DRUG PRICE NEGOTIATION RELEASED
CMS recently outlined in a
press release and
memo key dates and activities around implementing
the Inflation Reduction Act’s Medicare drug rebate and price negotiation provisions.
By September 1, 2023: CMS will announce the first 10 Medicare Part D drugs to be included in the drug price negotiation program.
By September 1, 2024: CMS will announce the negotiated maximum fair prices for those drugs, to take effect in 2026.
More drugs will be selected for negotiation, including those paid for under Part B, reaching 60 total subject to negotiation. There will be opportunities for engagement and public feedback
throughout the implementation process. The full timeline is available on the
CMS website.
QUALITY REPORTING OPEN THROUGH MARCH 31, NAACOS WEBINAR
ACOs can now report 2022 quality data via the QPP portal through March 31, 2023, at 8:00 pm ET. CMS recently published scoring changes
for 2022 due to measures affected by International Classification of Diseases, Tenth Revision (ICD-10) updates that took place mid-performance year. As a result of these changes, two
electronic clinical quality measures (eCQMs) will not be scored (i.e., screening for depression and follow-up plan, controlling high blood pressure). As a reminder, under the new APP scoring
rules, quality measures that are not scored are suppressed (not pay-for-reporting). This results in fewer measures contributing to the overall quality score.
Join a NAACOS webinar on February 1 from 2:00–3:00 pm ET to review key points to consider in the
quality reporting process and to learn quality reporting tips from your ACO peers. More information on quality requirements for
ACOs is available. CMS is also holding bi-weekly
support calls January 25–March 22 to assist with quality
reporting. ACOs can also contact the QPP Help Desk at 1-866-288-8292 or QPP@cms.hhs.gov with any questions or issues.
ACO PUBLIC REPORTING DEADLINE FEBRUARY 13
MSSP ACOs must update their public reporting webpages using the Public Reporting Template and Instructions (v6.1) by February 13, 2023. All ACOs must create and maintain a dedicated web page
to publicly report certain details about the ACO as required by statute, such as name, location, primary contact for the ACO, and other organizational details. These details must be up-to-date
both on the publicly facing website as well as in the ACO-MS. The public reporting template and instructions are available in the ACO-MS
Knowledge Library; ACOs should contact their ACO coordinators with any questions about reporting obligations.
ENHANCING ONCOLOGY MODEL FACTSHEET AVAILABLE
The CMS Innovation Center published a three-page factsheet describing key elements of the
benchmarking process for the upcoming Enhancing Oncology Model. It includes the steps used to arrive at a benchmark price for each episode in the model, which launches on July 1.
Welcome New Business Partners
DataGen
DataGen offers a wide variety of healthcare analytical and consulting services.
datagen.info/v2/
Heartbeat Health
Heartbeat Health is a Virtual-First Cardiology solution revolutionizing the delivery of cardiovascular care. Our virtual-first model delivers early and preventive care
before heart health conditions develop and progress.
heartbeathealth.com
EDUCATION OPPORTUNITIES
UPCOMING DISCOVERY CALL ON END-OF-LIFE DOCUMENTATION
The End-of-Life Documentation Discovery Call will be held on January 31 from 3:00–4:00 pm ET. Dr. Nathan Moore from BJC will review the improvement work they are currently doing in this area.
This discovery call will be informal with Dr. Moore’s presentation followed by an open forum for discussion.
Sign-up to join this discovery call.
This platform allows ACOs to connect with others who are working on the same types of initiatives to gather experience and achieve better outcomes. ACOs can use this opportunity to listen to
Dr. Moore’s presentation, add from their own experience, and ask questions. In addition, NAACOS has posted recordings from previous discovery calls including the call on the EPIC Claims
Ingestion Process, HCC Gaps, and others on our new discovery call page.
VIRTUAL AFFINITY GROUP MEETINGS START TODAY
These virtual peer-to-peer opportunities are offered to NAACOS members throughout the year in addition to the in-person sessions at our spring and fall conferences. Like the conference
sessions, these virtual meetings provide peers in similar positions in value-based care settings with a forum to meet and discuss hot topics, network, and exchange ideas. The meeting link will
be provided in the confirmation e-mail when you sign up for each group, and it will work for all future meetings. You may sign up for as many groups as you are interested in. NAACOS ACO
Members who have not signed up, can register for NAACOS Affinity Groups via the links below.
GRAB THE LAST FEW SEATS TO THE WINTER 2023 BOOT CAMP
Join us at the Marriott Orlando Airport Lakeside, February 9–10 for the Winter 2023 Boot Camp. Sponsored by
Ciox and Olio, 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.
Full agenda is available!
**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.**
ACO EXPERTS TO LEAD SPRING 2023 CONFERENCE SESSIONS
Join us May 3–5 for the NAACOS Spring 2023 Conference at the Hilton Baltimore Inner Harbor. In addition to plenaries with CMS officials and other value-based care leaders, this two-day,
in-person event will feature 16 breakout sessions with actionable knowledge for new ACOs joining the MSSP and REACH models, rural
ACOs, independent primary care ACOs, and experienced ACOs in all models. 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!
MEDICAID LEARNING LAB MEETINGS CONTINUE FEBRUARY 3
There is still time to join the Medicaid Learning Lab and obtain CEUs and a certificate of completion. The virtual meetings
in this series continue February 3 from 2:00 pm to 3:30 pm ET and will meet monthly for 90-minute sessions. 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 and enhance patient engagement in the Medicaid population. This series will offer a platform to gain knowledge on these topics and
create a strategic plan for implementation options within your ACO.
Our February 3 virtual session will feature Steven R. Counsell, MD, Executive Director, Geriatric Resources for Assessment and Care of Elders (GRACE) Team Care Program, and Dawn Butler, MSW,
JD, Director, GRACE Training & Resource Center, who will discuss the GRACE model of care. Sign up today!
MEMBERSHIP UPDATE
PARTNER CIRCLE SPOTLIGHT: REAL TIME MEDICAL SYSTEMS
Real Time Medical Systems is the KLAS Rated, HITRUST-Certified Interventional Analytics solution that turns post-acute EHR data into
actionable insights. Serving health care organizations nationwide, Real Time improves value-based outcomes by reducing hospital admissions, accurately managing reimbursements, detecting early
signs of infectious disease, and advancing care coordination through post-acute data transparency.
Areas of focus: Care management and coordination, data analytics/claims line feed, financial and reimbursement services, population health management, post-acute care (provider/services), and
quality reporting management.
NAACOS Partner Circle enables a select group of vendors to engage with NAACOS and its leadership on critical issues
facing ACOs.
MEMBER RESOURCES
RESOURCE REVIEW: HOW TO FIND PARTNERS TO MEET YOUR ACO NEEDS
Did you know NAACOS has a business partner directory that provides information on vendor products and contact
information? We are often asked for recommendations for certain ACO needs. While we do not recommend any one business partner over another, we do provide company descriptions and contact
information to allow ACOs to easily create a list of options to explore. The search option on the directory webpage allows ACOs to search for vendors by category.
WHAT WE’RE WATCHING: NEWS ABOUT ACOS AND HEALTH CARE
The Medicare Payment Advisory Commission (MedPAC) held its January public meeting and
voted on recommendations to increase Medicare payments for hospitals and physicians, while reducing
payments to post-acute care providers. The payment recommendations will be published in the commission’s March Report to Congress.
CMS will hold its annual CMS Quality Conference virtually May 1–3. The conference will focus on having an equitable foundation for quality in health care and will cover eight tracks
including: patient safety; advancing health equity; expanding access to quality and affordable behavioral health care; collecting and using quality data; engaging partners and
communities; healthcare system resiliency; high reliability and quality improvement and new innovations/technologies. Registration will open January 31.
The Medicare and CHIP Payment and Access Commission (MACPAC) is hosting their
January public meeting this week on January 26–27, and will discuss a variety of topics
including home and community-based services (HCBS), Medicaid managed care, and the
Commission’s response to the
Senate RFI on improving care for dual eligible
beneficiaries.
