ASK CONGRESS TO EXTEND ADVANCED APM INCENTIVE PAYMENTS NAACOS and the Alliance for Value-Based Patient Care are organizing a sign-on letter asking Congress to extend incentives for advanced alternative payment models (APMs). With the eligibility to earn advanced APM incentive payments set to expire at the end of 2023, progress towards value-based care could stall further. ACOs, hospitals, and practices should sign to demonstrate that lawmakers need to act before the end of the year. If you would like to have all the practices in your ACO listed as signers on the letter, please send a list to Robert Daley. The new deadline to sign on is October 13.
WELCOME NEW BUSINESS PARTNERS
NAACOS IS HIRING! We are seeking a Senior Director of Payer Policy to develop and implement approaches to support members in accountable care arrangements across payers. The role will be responsible for identifying policy and operational solutions to encourage adoption, growth, and success in value-based arrangements in Medicare Advantage, Medicaid, commercial insurance, and direct to employer. Please spread the word on LinkedIn and encourage any strong candidates to submit to jobs@naacos.com.
ALLIANCE FOR VALUE-BASED PATIENT CARE UPDATES The Alliance for Value-Based Patient Care, of which NAACOS is a founding partner, aims to bolster and sustain support for value-based care. Follow the Alliance on LinkedIn and Twitter. Recent updates include:
Publication of an issue brief explaining to policymakers how accountable care improves patients’ lives by creating better incentives for providers. The brief is meant to serve as a conversation starter with policymakers unfamiliar with value-based care. Read the brief and share with policymakers.
Issuing a response to a recent New York Times’ Upshot piece that pointed out the recent slowdown in Medicare spending. Unfortunately, the story failed to acknowledge the contributions of accountable care, which others have said helps lower the spending growth rate. Share on LinkedIn with your followers.
As part of its communication efforts, the Alliance highlights patient and provider stories that demonstrate how value is working. We need your stories. Submit any stories from your organization. We are also happy to schedule a call to capture your stories. Contact David Pittman for more information.
NAACOS PRESENTS CONGRESSIONAL VALUE AWARDS At our fall conference NAACOS members went to Capitol Hill to educate lawmakers about ACOs and call on them to continue supporting accountable care. We also met with Reps. Darin LaHood (R-IL), Suzan DelBene (D-WA), Larry Bucshon (R-IN), and Kim Schrier (D-WA) to present them with our Champion of Value in Health Care Award. If your ACO has locations in these states, please reach out to their offices and thank them for the leadership and support of ACOs.
CONGRESSIONAL UPDATES
CONGRESS TEMPORARILY AVOIDS GOVERNMENT SHUTDOWN Over the weekend lawmakers reached an agreement that extends current government funding levels until November 17. It also provides a temporary funding extension for community health centers and health workforce programs, and it delays Medicaid disproportionate share hospital (DSH) payment cuts. Congressional leaders will now focus on reaching an agreement that will provide for a longer-term extension of funding and address expiring health programs.
As you have probably seen, in a historic first, Rep. Kevin McCarthy (R-CA) was ousted as House speaker on Tuesday. House Republicans will now need to select a new leader. This process may slow progress on reaching a new agreement for long-term funding.
Regardless of the political showdowns, NAACOS will continue advocating for Congress to include an extension of the advanced APM incentive in the next spending package. Please help us by signing the stakeholder letter coordinated by NAACOS and the Alliance for Value-based Patient Care, that asks lawmakers to extend the incentives.
INNOVATION CENTER SAVINGS PANNED IN CONGRESSIONAL REPORT The Congressional Budget Office, the monetary scorekeeper for Congress, estimated that the CMS Innovation Center increased federal spending by $5.4 billion in its first decade and will cost an additional $1.3 billion in the decade ahead. The report pointed to the voluntary nature of participation as one of the reasons for the lack of savings and did not consider savings from the Medicare Shared Savings Program, which is not run by the Innovation Center.
Unfortunately, this report focuses on savings achieved and does not account for many aspects of value-based care such as provider burden relief, patient experience, clinical transformation, and the spill-over effect that occurs when providers apply value principles across all areas of care. NAACOS will address the challenges with this report through thought leadership and advocacy. If you receive inquiries from press or members of Congress, reach out to Aisha Pittman. We can support you with talking points and additional information.
ADMINISTRATION UPDATES
NEW STATEWIDE MODEL FROM CMS INNOVATION CENTER COMING The CMS Innovation Center has released information about a forthcoming state-based, all-payer, total- cost-of-care model. Dubbed the States Advancing All-Payer Health Equity Approaches and Development Model or “AHEAD” Model, CMS would give states money to implement payment innovations, including global hospital budgets and primary care programs designed to control the growth of spending. A fact sheet and FAQ document are available. Few details are available, and NAACOS is paying close attention to this model. We plan to host a webinar soon.
REQUEST YOUR 2022 MIPS TARGETED REVIEW BY OCTOBER 9 CMS will accept Targeted Review (download of PDF) requests for Performance Year 2022 Merit-Based Incentive Payment System (MIPS) scores through October 9. If you think your ACO’s MIPS score is inaccurate, submit a Targeted Review request by logging into the Quality Payment Program using the same credentials used to submit your 2022 MIPS data. CMS requires documentation to support a targeted review request, and a CMS representative may reach out to obtain additional documentation. 2022 performance scores will dictate 2024 MIPS payment adjustments received for ACO professionals. As a reminder, MIPS adjustments are counted as ACO expenditures.
EDUCATION OPPORTUNITIES
SAVE THE DATE: FEBRUARY 2024 BOOT CAMPS Mark your calendar to join us in Orlando for our winter boot camps! On February 8–9, NAACOS will host two concurrent boot camps on (1) data and analytics and (2) best practices for clinical operations. Each boot camp is limited to 100 ACO employees with lunches and a reception held for all participants. Registration opens on October 18. More information on the agenda, housing, and registration will be posted soon.
WEBINAR ON MAKING CARE PRIMARY MODEL Join NAACOS on October 24 at 2:00 pm ET for an informative webinar discussing the CMS Innovation Center’s latest primary care model, Making Care Primary (MCP). The MCP application portal is open now through November 30 for eligible practices in participating states. Importantly, the model is intended to attract new entrants to value-based care, with three progressive tracks advancing care delivery and payment reform. Concurrent participation in a Medicare ACO program is prohibited. In this webinar, we will discuss the model details and implications for the move to accountable care. Register today!
WEBINAR ON INTEROPERABILITY IN VALUE-BASED CARE Join us for a webinar on October 18 from 2:30 to 3:30 pm ET to learn about the role federally mandated and voluntary electronic standards and operating rules can play in standardizing and securing the exchange of health information, as well as how they can be leveraged to support the adoption and administration of value-based care programs. Attendees will hear from Erin Weber, Vice President, and Michael Phillips, Senior Manager, from CAQH CORE—the HHS-designated Committee on Operating Rules for Information Exchange—about their work to:
streamline identification and engagement of patients attributed to a value-based care contract,
strengthen collection and sharing of socio-demographic information,
and facilitate the documentation of secondary diagnoses that support risk adjustment and quality measurement methodologies.
UPCOMING PARTNER SPONSORED WEBINARS Incentivizing Your PAC Network to Meet Your Contract Metrics— Sponsored by Real Time Medical Systems Network Join us for a webinar on leveraging post-acute care (PAC) networks in value-based care. Learn proven strategies to boost PAC engagement and drive care outcomes. Discover the power of live clinical data transparency for successful PAC network management. Don’t miss out—PAC outcomes are your outcomes!
Speakers: Phyllis Wojtusik, EVP, Value-Based Care, and Kristen Klopp, Network Program Manager from Real Time Medical Systems
Date / Time: October 10 from 2:00 to 3:00 pm ET
Navigating the Data Deluge: Transforming Chaos into Order for ACOs— Sponsored by Databridge Learn how ACOs can tame the data deluge, transform it into a powerful resource, and improve patient care. Explore data integration, real-world success stories, and strategies to drive data-driven decision-making. Join us for insights that can revolutionize value-based care and enhance patient outcomes.
Speakers: Chris Valerian, CEO, Integrity Health, and Dave Magnan, Founder and CEO, Databridge
Join us for a unique opportunity to discover how Lifepoint Health leverages clinical data for ACO and Population Health goals. Learn how they excel in value-based care contracts and HEDIS compliance, staying ahead of CMS requirements and prioritizing interoperability and population health initiatives.
Speakers: Carol Ann Hudson, RN, AVP, Clinical and Quality Operations, Population Health, Lifepoint Health, and Bhushan Kadu, Senior Delivery Manager, ACO Performance Pathway with MRO
Date / Time: October 31 from 1:30 to 2:30 pm ET
MEDICAID AND AWV LEARNING LABS Learning Labs are designed to give members a deep dive into fundamental strategies in accountable care and to foster exchange among peers with frontline experience. These interactive labs include expert presentations, experiences from member ACOs, brainstorming activities, and peer-led discussions. Join us as we continue the Medicaid Learning Lab through December and kick off the Annual Wellness Visit Learning Lab this month.
The Medicaid Lab meets the first Friday of each month from 2:00 to 3:30 pm ET with the next meeting occurring on October 6 and featuring Rachael Lesch, RN, MBA, Vice President of Population Health and Performance Excellence for CentraCare. Rachel will discuss her team’s approach to value-based care in the Medicaid space including patient engagement efforts and their team’s approach improving the health and wellbeing of their Medicaid beneficiaries. In November we will hear from Dr. Art Jones, MD, who was one of the founders of Medical Home Network (MHN) ACO and continues to serve as its Chief Medical Officer. MHN is comprised of 11 Federally Qualified Health Centers and three health systems that serve 146,000 Chicago-area Medicaid recipients. Sign-up to attend the final three learning lab meetings discussing Medicaid contracts and design.
AWVs are an ongoing opportunity for ACOs to engage participants, plan their care, and increase quality scores in the process. Starting October 19, we will hold monthly AWV Learning Lab sessions on the third Thursday of each month from 2:00 pm to 3:30 pm for six sessions. At the October meeting, Carrie Sevarns, Senior Population Health Manager, and Mandy Barber, Clinical Coding Specialist at Signify Health will review AWVs, including an overview of the types, minimum components of the visit, patient benefits, and guidance on general coding and billing. November’s meeting will focus on the topic of structuring electronic health records (EHR) for successful documentation for billing requirements and care planning. Kevin McNeill, M.D., Associate Medical Director, Lehigh Valley Health Network ACO, will presenting. Register here to join the AWV Learning Labs.
MEMBERSHIP
NAACOS MEMBER SURVEY: YOUR VOICE, YOUR IMPACT! Check your inbox for an exclusive invite to participate in the 2023 ACO Member Survey. Complete this survey and be a part of shaping the future of our organization. Your insights are invaluable in helping us serve you better.
NEW RESOURCE TO ASSESS SPECIALTY CARE PERFORMANCE NAACOS and the Institute for Accountable Care (IAC) are offering complimentary episode spending reports to ACO members, now updated with 2022 Medicare data.
Episodes-of-care data are a valuable tool to assess specialist performance and can help ACOs identify referral partners and clinical improvement opportunities. The complimentary reports profile an ACO’s episode volume and spending broken out by type of service, the relative efficiency of the care your beneficiaries received, and a state-level comparison.
Questions on how to use your report or obtain more data? Contact analytics@institute4ac.org. IAC can produce similar reports for any hospital or physician group in the country under a separate agreement. As an independent, non-profit research institute, IAC is the official research partner of NAACOS and supports organizations navigating value-based payment and care delivery.
WHAT WE’RE WATCHING: NEWS ABOUT ACOS AND HEALTH CARE
Health Affairs Forefrontpublished questions about the CMS Innovation Center’s new AHEAD model.
The Medicare Payment Advisory Commission (MedPAC) is holding a public meeting on October 5 to discuss updates to Medicare payment rates, staffing ratios at nursing facilities, payments for inpatient rehab, and the price of generic drugs under Medicare Part D.
