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FINAL 2025 MEDICARE PHYSICIAN FEE SCHEDULE RULE RELEASED
The Centers for Medicare and Medicaid Services (CMS) released the final 2025 Medicare Physician Fee Schedule (PFS). NAACOS will be publishing an analysis and holding a webinar discussing the final rule on Tuesday, November 19, at 2:00pm ET. Sign up Today!
The final rule contains numerous changes for the Medicare Shared Savings Program (MSSP) that NAACOS has been advocating for, including establishing permanent policies for anomalous billing and easing requirements around beneficiary notifications. However, the rule does not address the ratchet to ACO benchmarks, and more work is needed to address concerns related to quality reporting.
Additional resources on the PFS final rule:
MSSP GENERATED $5.2 BILLION IN GROSS SAVINGS LAST YEAR
The MSSP produced its highest level of savings in history last year. Data from CMS shows the 453 ACOs collectively generated $5.2 billion in gross savings and $2.1 billion in net savings after accounting for shared savings and losses. ACOs generated $504 in gross savings per beneficiary. Overall, 85 percent generated savings to CMS and 69 percentearned shared savings, which totaled $3.1 billion. All of those savings were program highs. Importantly, all ACOs met the quality standard.
NAACOS issued a statement congratulating MSSP ACOs on their success and encouraging ACOs to tout their results publicly. CMS says they will process shared savings payments starting November 14. Congratulations to these ACOs for their hard work.
NAACOS, ALLIANCE RECOGNIZED FOR COMMUNICATIONS CAMPAIGN
PRNEWS, the leading publication of public relations and communications professionals, recently honored NAACOS and the Alliance for Value-Based Patient Care, of which NAACOS is a founding member, with its Platinum Awards. Specifically, we were recognized with an honor mention in the public affairs category for our campaign on extending Medicare’s Advanced APM bonus.
JOIN NAACOS FOR A 2024 POST-ELECTION WEBINAR
On Tuesday, Donald Trump secured enough votes to be reelected as President of the United States. Senate Republicans also won enough races to reclaim the majority for the first time in four years. Meanwhile, the battle for the majority in the House of Representatives is razor thin and will come down to a handful of highly competitive races. With several races still too close to call it might be days before we know which party controls the House.
As Washington prepares for a new administration and shifting power dynamics in Congress, join the NAACOS advocacy team and our political consultants for a post-election webinar on Wednesday, November 20, at 3:00 pm ET for a deep dive into the 2024 election results and their impact on health care going forward into 2025.
HOUSE MEMBERS SEND LETTER TO CMS ON DIGITAL QUALITY & CMMI TRANSPARENCY
Digital Quality—Representatives Blake Moore (R-UT) and Darin LaHood (R-IL) sent a letter to CMS Administrator Chiquita Brooks-LaSure asking the agency to reconsider how ACOs report quality measures. The lawmakers encouraged CMS to provide additional flexibility to ACOs, especially those with small independent practices, during the transition to digital quality reporting.
ACO REACH—Representatives Dan Crenshaw (R-TX) and Kim Schrier (D-WA) sent a letter to CMMI Director Liz Fowler requesting information on the decision-making process related to the development, implementation, and evaluation of innovative payment and service delivery models by CMMI.
LAWMAKERS PUSH TO STOP PHYSICIAN PAYMENT CUTS
Lawmakers introduced the bipartisan Medicare Patient Access and Practice Stabilization Act, which would prevent Medicare physician payment cuts for 2025. NAACOS is pleased to support this bill, which will help to stabilize the physician payment system, ensuring that providers have the resources necessary to transition into and continue to succeed in accountable care models. NAACOS thanks Representatives Greg Murphy (R-NC) and Jimmy Panetta (D-CA) for their leadership on the bill, and all of the co-sponsors for their commitment to ensuring that Medicare beneficiaries retain access to high-quality, affordable care.
SENATORS RELEASE OUTLINE FOR HOSPITAL SITE-NEUTRAL PAYMENT CHANGES
Senators Bill Cassidy (R-LA) and Maggie Hassan (D-NH) released a legislative outline that proposes changes to Medicare’s site-neutral payment policy for hospitals. While the proposal would reduce outpatient hospital reimbursements, it also includes reinvestments into hospitals that serve rural and underserved populations, along with hospitals participating in value-based payment models. In discussions with Congressional staff, NAACOS has encouraged policymakers to ensure that any site-neutral payment policy changes do not harm providers in accountable care models. Given the sensitive nature of site-neutral payment reforms, NAACOS would like to hear feedback from members regarding these proposals to help inform future advocacy on this issue. Please share feedback with Robert Daley.
CONGRESSIONAL DEMOCRATS CALL FOR MORE OVERSIGHT OF MEDICARE ADVANTAGE
Senate Finance Committee Chair Ron Wyden (D-OR), House Ways and Means Committee Ranking Member Richard Neal (D-MA), and House Energy and Commerce Committee Ranking Member Frank Pallone (D-NJ) sent a letter calling on CMS to reform the prior authorization process, simplify the experience of choosing a Medicare plan, and reduce marketing abuses. Efforts are still underway in Congress to pass legislation during the lame duck to reform MA’s prior authorization process.
2023 MIPS FINAL SCORES AND 2025 MIPS PAYMENT ADJUSTMENTS
Data released by CMS states the maximum Merit-based Incentive Payment System (MIPS) bonus in Payment Year 2025 will be 2.15 percent. The average MIPS adjustment is 0.56 percent and median is 0.90 percent. For comparison, the Advanced APM bonus in payment year 2025 is 3.5 percent. More detail from CMS is available in its MIPS Payment Adjustment User Guide.
CMMI MODEL UPDATES ON REACH, AHEAD, AND IOTA
- ACO REACH: CMS will update the ACO REACH rate book and benchmarks for 2025, which are expected to be delivered next month. This is a result of needed updates to geographic adjustments resulting from changes to Medicare’s hospital wage index coming next year.
- States AHEAD: A region of New York state and Rhode Island will participate in the States AHEAD Model, which aims to implement hospital global budgets and enhanced primary care payments to participating states. Maryland, Vermont, Connecticut and Hawaii were already announced as participants.
- Increasing Organ Transplant Access (IOTA) Model: CMS has yet to publish the final rule implementing the mandatory organ transplant model and will have to delay the start beyond the originally proposed date of January 1, 2025.
CMS RELEASES HOSPITAL OUTPATIENT, HOME HEALTH, AND RENAL DISEASE FINAL RULES
MSSP PUBLIC REPORTING DEADLINE
ACOs participating in MSSP have until Monday, December 2, 2024, to update their public reporting webpages with performance year 2023 financial and quality performance results. ACOs must use the latest public reporting instructions and template provided by CMS, which is available under the “Public Reporting” section of MSSP Guidance & Specifications and in the ACO-MS Knowledge Library.
BOOT CAMP SERIES STARTS NEXT WEEK – REGISTER TODAY!
NAACOS’ Boot Camp series starts next week! The virtual Boot Camp 101 is ACO beginner-to-intermediate learning featuring Clinical Operations on November 14 and for Data and Analytics on November 21. Each of these boot camps is a one-day virtual event with opportunities to interact with fellow participants and ask questions of faculty. All attendees receive access to the recordings of the live events to rewatch as needed. The events will run from 10:00 am to 6:00 pm ET in an interactive virtual environment. Detailed agendas are available.
Need a quick review or understanding of ACO basics? NAACOS is currently building a curriculum of Fundamentals, which are on-demand videos covering ACO essentials like compliance, basic data and analytics, and quality reporting for both MSSP and REACH. Compliance fundamentals are posted, and new topics will be added frequently. These videos are free to both members and non-members.
Registration is now open for Boot Camp 201! Our Boot Camp 201 is an in-person event for experienced ACO employees and/or those who have completed our Boot Camp 101s. This boot camp will be held February 6–7 in Orlando where we will offer two concurrent tracks on Clinical Operations and Data and Analytics. Register today!
SAVE THE DATE FOR THE SPRING 2025 CONFERENCE!
Meet us at the Baltimore Hilton Inner Harbor April 22-24 for the Spring 2025 Conference! The agenda will feature leading health care experts and CMS officials sharing timely and essential information for ACOs. Registration will open next Wednesday, November 13 for both in person and virtual participation. Register early and save!
**Please note the pattern for the Spring 2025 Conference is different – the dates are Tuesday-Thursday.**
REGISTER FOR WEBINAR ON ADVANCED DATA SHARING AND COLLABORATION
Health care organizations are increasingly challenged by a growing number of critical use cases ranging from prior authorization, utilization review, and risk adjustment to care management and quality improvement that demand efficient access to clinical data. Join leaders from NAACOS business partner, Xsolis, for the sponsored webinar, “Practical Application and Solutions for Advanced Data Sharing and Collaboration Across Providers and Health Plans.” This event will explore innovative strategies for optimizing data workflows, enhancing operational efficiency, and driving better outcomes for both providers and payers leveraging practical, proven AI models and best practice workflows. Webinar will be held on Wednesday, Nov. 13, 2024 from 2:00 – 3:00 PM ET and is free to attend. Register today!
VIRTUAL AFFINITY GROUPS THROUGH YEAR END
NAACOS Affinity Groups focus on peer-to-peer exchange of current ACO and population health issue with four groups meeting now through year end. You may join one or more groups depending on your current roles and responsibilities. You will need to sign up individually for each group that you would like to participate in – once you have signed up, you will receive the Zoom log-in information for the virtual meetings. This is your time for discussion with your peers on timely topics related to your value-based care journey.
Data and Analytics
November 12 from 3:00 to 4:00 pm ET
Sign up for the Data and Analytics Affinity Group
Executive
November from 3:00 to 4:00 pm ET
Sign up for the Executive Affinity Group
CMO and Clinical
December 3 from 3:00 to 4:00 pm ET
Sign up for the Clinical Affinity Group
Compliance and Legal
December 10 from 3:00 to 4:00 pm ET
Sign up for the Compliance and Legal Affinity Group
INTERESTED IN ADDRESSING STRUCTURAL RACISM IN YOUR HEALTH SYSTEM?
The Association of American Medical Colleges (AAMC) invites health care organizations, along with patient and community partners, to apply for up to $300,000 ($400,000 for safety net institutions) to address racial justice, health equity and systems change. Those selected for this initiative will work with JUSTIC SQUARED, a learning and action collaborative, to measure and remove racism from clinical, operational and administrative diagnostics. AAMC and JUSTICE SQUARED will select 12 leadership teams for this initiative. Teams must be registered by December 15, 2025, and phase one applications are due January 15, 2025. To learn more, visit the JUSTICE SQUARED Call for Proposals.
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WHAT WE'RE WATCHING: NEWS ABOUT ACOS AND HEALTH CARE |
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