2023
CALL FOR VOLUNTEERS OPEN THROUGH OCTOBER 26 NAACOS is soliciting
volunteers from our ACO members to serve on a committee or share their knowledge
via a conference session or webinar. Those interested need to complete the Call for
Volunteers application before October 26. NAACOS leadership will select
appropriate individuals to serve on 2023 committees or participate in educational
activities. Those who volunteer for committees will be notified but those who wish to
present may not hear until we need someone with their expertise. If you have any
questions or have difficulty with the form, please contact Anna
LaFayette.
NAACOS ADVOCACY
STAKEHOLDER
LETTER ON ADVANCED APM INCENTIVE PAYMENTS More than 800 health care
organizations sent a letter to Congress last week asking leaders to extend the
5 percent Advanced Alternate Payment Model (APM) incentive payments before the end of
the year. We are hearing from congressional staff that an extension of the incentive
payments is under consideration. This letter is an important step in signaling to
lawmakers that an extension is critical. We thank all the ACOs and medical practices
that signed onto this letter. We encourage you to share this letter with your contacts
on Capitol Hill.
NAACOS
CO-HOSTS CONGRESSIONAL BRIEFING ON VALUE Focus on the Advanced APM 5
percent incentive payment and qualifying participant threshold was heightened last week
when NAACOS, America’s Physician Groups, Premier, and several other coalition partners
hosted an in-person briefing for Capitol Hill staff. The briefing was attended by more
than 150 Capitol Hill staff and stakeholder registrants and is part of our ongoing
efforts to educate law and policymakers about value-based care and the advanced APM
incentive payment. Opening remarks were provided by U.S. Representative Brad Wenstrup
(R-OH), an original cosponsor of the Value in Healthcare Act. The briefing was moderated
by Mark McClellan, MD, former CMS administrator, FDA commissioner, and founding Director
of the Duke-Margolis Center for Health Policy at Duke University, with panelists Kisha
Davis, MD, Vice President of Health Equity, Aledade, Inc., Robert Fields, MD, Chief
Population Health Officer, Mount Sinai Health System, Jon Regis, MD, Business
Development Executive, Village Medical, and Richard Shuman, MD, CEO, Baycare Health
Partners. A recording of the briefing is available.
Welcome
New ACO Member
Heritage
Valley Healthcare Network ACO, LLC Beaver,
PA
REMINDER:
NAACOS SEEKS FEEDBACK ON MACRA REFORMS A group of House lawmakers
released a request for public comment last month on actions Congress can
take to stabilize the Medicare payment system and improve the Medicare Access and CHIP
Reauthorization Act (MACRA). NAACOS will be submitting comments to advocate for an
extension of the 5 percent Advanced APM incentive payment, along with providing
longer-term policy recommendations to improve MACRA. 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 Wednesday, October 12.
CONGRESSIONAL UPDATES
PRESIDENT
SIGNS CR TO KEEP GOVERNMENT FUNDED Last week the House and Senate
passed a continuing resolution (CR) (H.R. 6833) to fund the government through December
16. The CR includes a five-year extension of Food and Drug Administration (FDA) user
fees for prescription drugs, medical devices, generic drugs, and biosimilar biological
products. The CR punted several issues that could potentially be worked out in the lame
duck by extending only some programs’ funding through the CR’s deadline of December 16.
These include some FDA and federal health programs administered by the Department of
Health and Human Services (HHS), such as activities and hospital payment adjustments for
certain low-volume hospitals (LVH) and the Medicare-Dependent Hospital (MDH) program.
With the CR complete, lawmakers have left Washington until after the
mid-term elections. During this time congressional committees and offices are working to
identify priority end-of-year proposals. Health care priorities include extension of the
advanced APM incentive payments, measures to address Medicare physician payment cuts,
ambulance payments, policies to extend COVID-19 Public Health Emergency (PHE) waivers,
among other issues. NAACOS will be working to ensure the extension of the advanced APM
incentives remains a priority.
ADMINISTRATIVE
UPDATES
MIPS
TARGETED REVIEWS DUE OCT. 21 The last day to submit a Merit-Based
Incentive Payment System (MIPS) Targeted Review is October 21, 2022. ACOs who question
the accuracy of their MIPS scores can submit a Targeted Review request by signing-in to
the Quality Payment Program (QPP)
website and selecting “Targeted Review.” CMS will contact applicants regarding
documentation required to support the targeted review request, which varies by
circumstance. All review decisions are final. More information is available in the CMS Targeted Review Guide.
APPLICATION
DEADLINE FOR NEW ONCOLOGY MODEL EXTENDED The CMS Innovation Center has
extended the deadline to apply to its new Enhancing Oncology Model (EOM) until 11:59 pm ET on October 10.
EOM is a total cost of care model that builds on the lessons learned in the Oncology
Care Model (OCM). NAACOS has developed a summary of the model for members, outlining elements such as its
emphasis on health equity, electronic patient reported outcomes (ePROs), and lower
enhanced oncology services payments. CMS also recently published a set of frequently
asked questions around the model that ACOs may find useful. Applications are
non-binding, and CMS does not expect to offer another application period for the model.
Decisions on applications are expected later this year.
EDUCATIONAL OPPORTUNITY
NAACOS
2023 WINTER BOOT CAMP: REGISTRATION IS OPEN! The 2023 Winter Boot
Camp, February 9–10, will focus on clinical, operational, and quality topics including
how to best utilize and assess your network’s care management services, how to assess
your post-acute network and implement new programs and workflow, and how to implement
quality improvement projects into the clinical and administrative workflows. Learn tips
and tricks, new approaches to care, and lessons learned by some of the top performing
ACOs in the country during this event. Sign up early to save your seat!
WHAT
WE’RE WATCHING
NQF
PUBLISHES RECOMMENDATIONS ON LEVERAGING EHR SOURCED MEASURES The
National Quality Forum (NQF) recently published recommendations on how to leverage electronic health record
(EHR) sourced measures to improve care coordination and communication for patient care
and quality measurement. The report calls on stakeholders to develop new, standardized
EHR data elements to document and assess care communication and care coordination,
including through expanding patient and caregiver driven data elements.
NQF
MAP REPORT RECOMMENDS MAINTAINING MSSP MEASURES The Measure
Applications Partnership (MAP), convened by NQF, met to review measures for potential
removal from various CMS programs. The final report discusses 32 measures across six programs, and no
measures were recommended for removal from MSSP. This fall, the MAP will reconvene to
review measures under consideration for addition. NAACOS participates in the Clinician
Workgroup, which provides input on the MSSP measure set.
MASSACHUSETTS
EXTENDS MEDICAID ACO PROGRAM THROUGH 2027 This week, CMS approved Massachusetts’ proposal to expand and extend the
state’s Medicaid section 1115 waiver through December 2027. This includes plans to
expand the ACO and Community Partners programs, implement primary care capitation within
ACOs, advance health equity by providing incentive payments for ACOs and hospitals to
reduce disparities, and incentivize ACOs to invest in pediatric care coordination for
children with complex needs. Additional resources are available:
NEW
EVALUATION OF CPC+ IMPACTS ON COMMERCIALLY INSURED POPULATIONS A recent study
found that the Comprehensive Primary Care Plus (CPC+) model did not have statistically
significant impacts on cost or quality measures for privately insured populations in
Michigan. The authors recommend that in future primary care transformation models, more
funds be shifted into capitated arrangements so that primary care practices can engage
in broader practice transformation. These findings are consistent with CMS’s most recent
independent evaluation of the model. More information is
available in this NAACOS summary.
