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
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.
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.