NAACOS’
NEXT ACO REACH WEBINAR ON APRIL 4 Applications for the new ACO
REACH Model are due on April 22, which gives precious little time for ACOs to
understand the recently announced model. As such, NAACOS is holding its next webinar
on ACO REACH at 3:00 pm ET on April 4. On this webinar, you’ll hear from an MSSP ACO
about how they’re evaluating ACO REACH and what they view as the opportunities and
challenges. Also, a current DCE will react to the recently announced changes to the
Global and Professional Direct Contracting (GPDC) Model and what it means to them.
Lastly, we’ll walk through the application, showing tips and tricks for applicants
along the way. This follows up on NAACOS
March 10 webinar that provides an overview of ACO REACH. We hope these
webinars provide a deep dive into the model and help ACOs better understand what’s
the best path for them. Registration is free for current NAACOS members and business
partners as well as members of NAACOS’ ACO REACH Coalition.
Welcome
New Business Partners
Geniq Geniq
offers proven work low and analytics solutions for provider
groups, ACOs, and other health systems to succeed in
delegated risk markets. Geniq.com
Koda
Health Koda’s
flagship Advance Care Planning (ACP) software platform
provides everyday clinicians the ability to engage their
patients in valuable conversations about their care
preferences. kodahealthcare.com
HealthJay HealthJay
is a California-based tech company offering a transformative
Telehealth Operating System that is intended for use by
health and human service providers to break down access
barriers for vulnerable populations to access care. healthjay.com
Visby
Medical Visby
Medical’s proprietary technology development program
culminated in the world’s first instrument-free, single-use
PCR platform that fits in the palm of your hand and rapidly
tests for serious infections. visby.com
SPECIALIST
ENGAGEMENT CHALLENGES ADDRESSED IN UPCOMING LEARNING LAB NAACOS
will be kicking off our first Learning Lab activity on April 27 in conjunction with
the spring
conference in Baltimore. This lab will focus on specialist engagement and
incentives, and it is designed to provide a deep dive into fundamental strategies in
accountable care and to foster exchange among peers with frontline experience.
Additional resources available to members on specialist integration include previous
conference presentations found in our conference archives. Additionally, a copy of the ACO Guide to Specialist Manual is also available for your
review.
If you would like to attend the Learning Lab and are a NAACOS
ACO member, you can register at no cost. We are limiting participation to one person
per organization for this in-person event. Additional staff may participate in
follow up lab activities held virtually. Register Today! If a representative from your ACO has
expertise to present or would like to take a more active role in the lab, please
reach out to Melody Danko-Holsomback, NAACOS Vice President of Education, mdholsomback@naacos.com.
TELL
LAWMAKERS YOU SUPPORT ACO REACH Following advocacy efforts by
NAACOS, the Center for Medicare and Medicaid Innovation (Innovation Center)
announced on February 24 that GPDC would transition into a new ACO REACH Model in
2023 that focuses more on health equity and provider governance. While NAACOS
supports ACO REACH, there are still several lawmakers asking the Biden
administration to cancel the model. As questions about the benefits of value-based
care are raised on Capitol Hill, lawmakers need to hear from ACOs in their states
and districts. NAACOS is asking our members to contact their representatives today to show support for
value-based care and the new ACO REACH Model.
CONGRESS
PAVES WAY FOR 2022 HEALTH PRIORITIES Following passage of the
omnibus funding bill earlier this month, which included several high priority
healthcare items (e.g., the temporary extension of telehealth waivers),
congressional lawmakers are now focused on non-healthcare matters, such as the
conflict in Ukraine, passage of the America COMPETES Act, and the confirmation
hearing for U.S. Supreme Court nominee Ketanji Brown Jackson.
On the
healthcare front, legislators in the majority party are clearly outlining their
priorities for the remainder of the legislative year: drug pricing, mental health,
and user fee reauthorization are top issues. Additionally, depending on multiple
factors including the emergence of new COVID variants, more pandemic relief and
preparedness funding may also advance. The latter issue is particularly timely: as
of March 22, Health and Human Services’ (HHS) Uninsured Program is no longer
accepting new claims for COVID testing and treatments, and the administration has
been stressing the need for additional funding. The President’s 2023 Budget request
is also due this week, which will outline the administration’s upcoming priority
healthcare items.
NAACOS
PUBLISHES MSSP VS. ACO REACH COMPARISON CHART Recently, NAACOS has
published several resources on the newly announced Innovation Center model, ACO
REACH, as part of the NAACOS REACH Coalition. With the application window for ACOs
to participate in the REACH Model for Performance Year (PY) 2023 now open through
April 22, ACOs may be grappling with the decision to participate in the Medicare
Shared Savings Program (MSSP) or the ACO REACH Model. To highlight the key
differences between the advanced tracks of MSSP (Level E and Enhanced) and the
Professional and Global tracks of REACH, NAACOS has published a comparison chart for members. The chart describes general
program information, financial structures, beneficiary alignment methodologies,
quality requirements, and compliance and waiver information for each track. For more
information or if you have questions, you can contact ACOREACH@naacos.com.
PUT
YOUR DATA TO WORK AT NAACOS SUMMER BOOT CAMP Having the right data
at the right time is the key to understanding the underlying factors that determine
your ACO’s population outcomes and your success in value-based care. At the NAACOS 2022 Summer
Boot Camp on June 16–17 in Nashville you will learn from ACO leaders and
technical experts how to harness your data to drive positive performance outcomes.
Boot camp faculty will:
Demonstrate how to understand risk calculations analysis, comparison,
benchmarking, and trending,
Explore best practices for creating actionable dashboards and reports,
Provide information on considerations when building episodes within ACO
data,
Explain claims data variation and how to create accurate network reports for
acute and post-acute settings, and
Show how to use data requirements to drive practice transformation.
This boot camp is designed for the ACO leadership team, including executive
directors, population health staff, as well as data, analytics, and IT team members.
We will have workshops that speak the language of those responsible for data
management and reporting in ACOs. Registration is now open! Space is limited to 100 people!
Welcome
New Associate ACO Member
UpStream Greensboro,
NC
NAACOS
URGES MSSP ENHANCEMENTS In a letter to
CMS, NAACOS recently urged the agency to implement a number of program
enhancements to drive increased participation in MSSP. In particular, NAACOS urged
CMS to consider these policy recommendations for inclusion in the 2023 Medicare
Physician Fee Schedule Rule to reverse a concerning decline in participation. In the
letter, NAACOS urges CMS to restore shared savings rates to pre-Pathways levels,
address benchmarking flaws, and address flawed quality rules for ACOs, among other
things. NAACOS will continue to press CMS to make these needed changes to drive
additional participation in value-based care and to fulfill CMS’s goal of having all
Medicare patients in an accountable care relationship by 2030.
MSSP
APPLICATION DEADLINES ANNOUNCED Earlier this month, CMS issued
updated information on the MSSP application process and timeline for the January 1,
2023 start date. The Notice of Intent to Apply (NOIA) submission window opens on
June 1 and will close on June 7 at 12:00 pm ET. Be sure to gain access to the CMS ACO Management System (ACO-MS)
to submit your NOIA. ACOs must submit a NOIA in order to be eligible to submit a
full application, but the NOIA is nonbinding. Phase 1 of the application process
will open on June 8 and the window for this phase of the application closes June 29
at 12:00 pm ET. A CMS application toolkit is available with helpful guidance
and resources. Additional information about the application timeline is available and updated sample
applications will be posted soon. As a reminder, application dates are subject to
change.
QUALITY
REPORTING DEADLINE APPROACHES As a reminder, the last day to submit
PY 2021 quality data is March 31, 2022, at 8:00 pm ET. 2021 is the first year the
new quality scoring rules apply to all MSSP ACOs. Under the new Alternative Payment
Model [APM] Performance Pathway (APP) structure, for PY 2021 MSSP ACOs can choose to
report either 10 Web Interface measures or three electronic clinical quality
measures (eCQMs) or Merit-based Incentive Payment System (MIPS) CQMs (supported by a
registry). Reporting will take place via the Quality Payment Program (QPP) website.
CMS advises ACOs to ensure they have the necessary Health Care Quality Information
System Access Roles and Profile (HARP) accounts. ACOs can manage their HARP user
roles in the ACO-MS. This includes ensuring the ACO has a QPP Security Official
listed in the ACO-MS. CMS has provided tip sheets and user guides to assist with
this process, available in the ACO-MS. Access our new resource to learn more about your ACO’s quality reporting options for
2021 through 2025, as well as important changes to quality scoring that can have a
significant impact on your ACO and your shared savings.
SOCIAL
NEEDS INCLUDED IN THE PREVENT PANDEMICS ACT LEGISLATIVE PACKAGE
Following a letter signed by NAACOS and over 50 other organizations in
February, the Senate Health, Education, Labor, and Pensions (HELP) Committee has
included key social determinants provisions in the bipartisan Prepare
for and Respond to Existing Viruses, Emerging New Threats, and Pandemics Act
(PREVENT Pandemics Act). This includes the bipartisan, bicameral Leveraging
Integrated Networks in Communities (LINC) to Address Social Needs Act (S. 509/H.R. 6072), which will enable states to establish or enhance
community integration network infrastructure to facilitate cross-sector referrals
and manage the interconnected health and social needs of individuals. The bill passed the Senate HELP Committee on March 15.
NAACOS
SUBMITS FEEDBACK TO CMS ON BENEFICIARY ENGAGEMENT STRATEGIES This
week, NAACOS submitted comments in response to the Innovation
Center’s beneficiary engagement strategy, as discussed in a recent listening session. As part of the operationalization
of the strategic direction outlined in the 2021 strategy refresh paper, the Innovation Center intends
to incorporate beneficiary perspectives into model testing, implementation, and
evaluation. Incorporating diverse beneficiary perspectives in a meaningful way will
be necessary to achieve the Innovation Center’s health equity goals. Appropriate and
accessible beneficiary education will also be necessary to drive accountable care
and achieve the goal of having all traditional Medicare beneficiaries in an
accountable care relationship by 2030. NAACOS shared feedback on strategies to
improve beneficiaries’ understanding of and engagement with value-based care.
MEDPAC
RELEASES MARCH REPORT On March 15, the Medicare Payment Advisory
Commission (MedPAC) published its March report on Medicare payment policy. The report includes
recommendations on Medicare fee-for-service (FFS) payment systems, the Medicare
Advantage (MA) program, and the Medicare prescription drug program. Below are
highlights from the commission’s recommendations.
Payment: The commission recommends positive payment updates
in 2023 for three FFS payment systems (hospital, long-term care hospital,
and outpatient dialysis); no update for three systems (physician, ambulatory
surgical center, and hospice); and negative updates for three systems
(skilled nursing facility, home health, and inpatient rehabilitation
facility).
Telehealth: The commission recommends that the Secretary of
HHS require physicians and other health professionals, home health agencies,
and hospices to provide more information on the telehealth services they
provide. This information would be used to help policymakers assess the
impact of these services on access, quality, and costs.
Post-Acute Care: The commission included a chapter
outlining a prototype value-based payment program under a unified
prospective payment system for post-acute care services. The commission
concluded that implementation of a new payment system would be a multiyear
process that would eventually need to align regulatory and quality
incentives tied to MA and ACO payments.
Medicare Advantage: The report included data showing that
MA grew by 10 percent for the third consecutive year. MA is now projected to
cover a majority of eligible Medicare beneficiaries by 2023. The commission
further illustrated that Medicare spends 4 percent more on MA than it would
spend on FFS Medicare, and private plans in the aggregate have never
produced savings for Medicare. While MedPAC remains committed to including
private plans in the Medicare program, the commission has concerns that as
enrollment continues to grow, the current MA payment system will further
worsen Medicare’s fiscal sustainability.
On March 4, NAACOS sent a letter to the Biden administration asking CMS
to align risk adjustment policies across all of its programs, including traditional
Medicare and MA to avoid arbitrage and profit seeking based solely on risk scores.
NAACOS was encouraged that HHS Secretary Xavier Becerra said in an interview on
March 18 that the Biden administration is examining risk adjustment practices in MA
plans that lead to overpayments by Medicare.
PTAC
PUBLISHES ENVIRONMENTAL SCAN OF TOTAL COST OF CARE MODELS Earlier
this month, the Physician-Focused Payment Model Technical Advisory Committee (PTAC)
released an environmental scan that provides background information and
current perspectives on the role that population-based total cost of care (TCOC)
models can play in health care delivery transformation and the overall shift to
value-based care. PTAC is hosting a series of theme-based discussions dedicated to the
topic of population-based TCOC models in 2022, the first of which took place earlier
this month. PTAC’s June public meeting will focus on best practices in care delivery
for population-based TCOC models and the September public meeting will focus on
payment considerations and financial incentives related to these models. As part of
this series, PTAC has issued a request for input (RFI) on issues related to
population-based TCOC model design and implementation, which NAACOS will provide
comments on. More information on PTAC’s work and upcoming meetings can be found on
the PTAC site.
