NAACOS Newsletter for Members and Partners October 20, 2022

Table of Contents

2023 Call for Volunteers Open Through October 26

NAACOS ADVOCACY

Ask Lawmakers to Support 5 Percent Advanced APM Incentive
Direct Contracting Learning Discussion

CONGRESSIONAL UPDATES

Reminder: Lawmakers Request Input on Strengthening MACRA

ADMINISTRATION UPDATES

BPCI Advanced Extended Two Years
White House Directs CMMI to Address Drug Pricing
COVID-19 PHE Extended into January
CMS Publishes MA Star Ratings
NAACOS Recommends eCQM Pilot for ACOs
CMS Releases Second QP Snapshot Data
CMS Publishes New Resources from AHC Model

EDUCATION OPPORTUNITIES

Register Now for the Winter 2023 Boot Camp in Orlando
Next Round of Virtual Affinity Group Meetings Start Next Week
Learn About Managing Complex Patients and Caseload Capacity

MEMBER RESOURCES

Bolster Your ACO’s Compliance with NAACOS Manual

WHAT WE’RE WATCHING

NEW REPORTS SUPPORT NAACOS RECOMMENDATIONS

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

ASK LAWMAKERS TO SUPPORT 5 PERCENT ADVANCED APM INCENTIVE
A bipartisan group of House lawmakers is circulating a sign-on letter urging House leaders to support an extension of the 5 percent Advanced Alternative Payment Model (APM) incentive payments. Please ask your congressional representatives to join this letter. The deadline to sign is Wednesday, October 26.

DIRECT CONTRACTING LEARNING DISCUSSION
NAACOS’ October Direct Contracting Learning Discussion will take place this Friday, October 21 from 12:00 – 1:00 pm ET. Participation is limited to those participating in Direct Contracting in 2022. As such, advanced registration is required. If you have questions or additional topics you want discussed, please share them in advance by emailing directcontracting@naacos.com.

Welcome New Alliance Partners
Center for Sustainable Health Care Quality and Equity
nmqf-shc.org
GTMRx Institute
gtmr.org

CONGRESSIONAL UPDATES

REMINDER: LAWMAKERS REQUEST INPUT ON STRENGTHENING MACRA
Last month, a group of House lawmakers released a request for public comment 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 longer-term policy recommendations to improve MACRA. We will share our letter with members ahead of submission. Members can submit their own comments and recommendations to lawmakers by Monday, October 31.


ADMINISTRATIVE UPDATES

BPCI ADVANCED EXTENDED TWO YEARS
The Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model was set to expire on December 31, 2023 but has now been extended for two additional years. The model tests whether linking payments for episodes of care will improve care coordination and reduce expenditures while improving quality of care. The extension will include a new application opportunity to participate in the model in 2024 through 2025, which will be announced in early 2023. ACOs are permitted to apply as Convener Applicants. Existing Convener Participants will be allowed to remain in the model through the extension. More information is available.

WHITE HOUSE DIRECTS CMMI TO ADDRESS DRUG PRICING
As part of an Executive Order on lowering prescription drug costs, the White House tasked the CMS Center for Medicare and Medicaid (CMMI) with developing a plan to use models to lower drug costs. A report on the plan is due within 90 days. NAACOS will monitor the work and alert members to any potentially relevant news.

COVID-19 PHE EXTENDED INTO JANUARY
As expected, HHS Secretary Xavier Becerra renewed the COVID-19 Public Health Emergency (PHE), which will now extend until January 11. A number of Medicare policies are tied to the PHE, including CMS waiving shared losses for MSSP ACOs, removing COVID-19 treatment episodes from performance year expenditures, and broad application of telehealth waivers. More information can be found on the NAACOS COVID-19 page.

CMS PUBLISHES MA STAR RATINGS
CMS recently published Star Ratings for Medicare Advantage plans, and the number of plans receiving four or five stars fell from 68 percent this year to 51 percent next year. In a fact sheet, CMS attributed the drop to the COVID-19 PHE. Adjustments were made to protect plans from an unexpected drop in quality measures last year.

NAACOS RECOMMENDS eCQM PILOT FOR ACOS
The NAACOS Digital Quality Measurement Task Force recently published a paper with recommendations for CMS, the Office of the National Coordinator for Health Information Technology (ONC), and other stakeholders on how to ensure a successful transition to electronic clinical quality measures (eCQMs) and digital quality measures (dQMs) for ACOs. The paper recommends CMS not move forward with a program-wide eCQM requirement until technical capability is tested through a pilot with a small number of ACOs.

CMS RELEASES SECOND QP SNAPSHOT DATA
Qualifying APM Participant (QP) providers must receive at least 50 percent of their Medicare Part B payments or see at least 35 percent of Medicare patients through an Advanced APM entity to be eligible for a 5 percent incentive payment in 2024. CMS recently updated the Quality Payment Program Participation Status Tool based on the second snapshot of advanced APM data which includes data from January 1 through June 30.

CMS PUBLISHES NEW RESOURCES FROM AHC MODEL
CMS published new resources from the Accountable Health Communities (AHC) Model:
  • A case study on engaging clinical and community partners to identify a common referral platform.
  • An issue brief highlighting lessons learned about leveraging cross-sector data sharing to address health-related social needs (HRSNs) informed by focus groups and interviews with bridge organizations, health information exchange partners, health care providers, and community-based organizations (CBOs).
Welcome New Member

University of Washington Medicine
Seattle, WA

EDUCATION OPPORTUNITIES

REGISTER NOW FOR THE WINTER 2023 BOOT CAMP IN ORLANDO
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 and DCEs. Faculty from top-performing ACOs 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. The full agenda will be announced in the coming weeks. This boot camp will only be offered in person with no virtual option, and it is limited to 100 attendees. Boot camps are not open to business partners. Register NOW!

NEXT ROUND OF VIRTUAL AFFINITY GROUP MEETINGS START NEXT WEEK
New participants can still register for NAACOS Affinity Groups! 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 will 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 when you sign up for each group and will work for all future meetings. Please make sure to add the appointments to your calendars. LEARN ABOUT MANAGING COMPLEX PATIENTS AND CASELOAD CAPACITY
Join us on October 25 at 1:00 pm ET for a one-hour webinar highlighting Mount Sinai Health Partners (MSHP) and Keystone ACO’s newest care management models. Maria Basso-Lipani, VP of Care Management and Population Health, will provide a high-level overview of MSHP Care Management Model. She will discuss MSHP’s path to maximize the interdisciplinary team when it comes to patient segmentation and offer insights into MSHP’s use of the Johns Hopkins Adjusted Clinical Group (ACG) Tool to stratify patients for care management outreach. Joann Sciandra, VP of Care Coordination and Integration at Geisinger Health, will discuss the deployment of a care management playbook to better meet needs for increasing caseload capacity and the growing complexity of the population. The playbook aims to break down the care management model into tiering levels that provide a baseline assessment for every patient every time, to apply the appropriate intervention and dosing based on the need, to move patients through the tiering with defined timelines, to close gaps in care and graduation criteria, and to expand team members to include technology staff in order to better support patients. Sign up today!


MEMBER RESOURCES

BOLSTER YOUR ACO’S COMPLIANCE WITH NAACOS MANUAL
Developed by NAACOS in partnership with Wilems Resource Group, the Compliance Manual includes a robust set of policies and procedures that your organization can customize to meet individual needs. NAACOS ACO members may purchase the manual at a 50 percent discount.

Why should you purchase the manual? MSSP ACOs and DCEs are required to meet state and federal regulatory requirements, including health care fraud and abuse laws, privacy requirements, and the specific requirements of CMS. This manual is a necessary tool designed to provide template policies to help your leadership determine the best “next steps” for your organization and implement procedures to ensure compliance with program requirements.

Subscribe to NAACOS Compliance Manual today!


WHAT WE’RE WATCHING

NEW REPORTS SUPPORT NAACOS RECOMMENDATIONS
The Bipartisan Policy Center released a new report recommending that providers in risk-bearing APMs have flexibility to use telehealth with their patients, including the freedom to use audio-only visits and establish relationships through virtual visits. NAACOS has made similar requests to policymakers.

In a Health Affairs Forefront piece, authors detail a proposal of a new primary care payment option for MSSP ACOs, structured as a hybrid of population-based payments and fee-for-service, as a strategy for CMS to strengthen primary care. This elaborates on a piece coauthored by NAACOS’ president and CEO Clif Gaus, along with Hoangmai Pham of Institute for Exceptional Care and Ann Greiner of Primary Care Collaborative, encouraging CMS to leverage MSSP authorities and implement primary care payment reforms.