For Immediate Release
Contact: [email protected] or [email protected]
February 21, 2024
AHCA/NCAL, NAACOS Release Recommendations
To Enhance LTC Providers’ Rolein Value-Based Care
White Paper Focuses on Greater Participation in Accountable Care Organizations
WASHINGTON – The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) and the National Association of ACOs (NAACOS) today jointly released a set of recommendations that were recently shared with the Centers for Medicare & Medicaid Services (CMS) that, if implemented, would increase the participation of long term and post-acute care (LTPAC) providers in accountable care organizations (ACOs).
Fewer than 2,000 skilled nursing facilities (SNFs) participate in ACOs, representing less than 10 percent of SNFs nationwide, and nearly 70 percent of ACOs have no SNF participation. LTPAC providers face myriad challenges participating in CMS value-based care models, including ACOs, despite targeted partnerships’ ability to produce significant cost savings and care improvements. Current program policies in ACO models do not align well with LTPAC providers, including those that determine which patients ACOs are accountable for, setting financial benchmarks, and quality measures. But as one of the highest-cost and most complex patient populations, LTPAC presents a significant opportunity for improved resident outcomes and reduced costs to the Medicare program.
AHCA/NCAL and NAACOS convened a roundtable of stakeholders in 2023to address the challenges and, more specifically, develop recommendations on how LTPAC providers can more effectively participate in ACOs.
“There is a tremendous opportunity for long term and post-acute care providers to lead the way with these value-based programs,” said Nisha Hammel, AHCA/NCAL Vice President of Population Health Management. “We gathered this group of thought leaders to determine how we can best support this shift to coordinated care and encourage CMS to further the value and role of these providers as effective partners.”
The paper focuses on two priority areas. First, how can existing risk-based arrangements, such as the ACO Realizing Equity, Access, and Community Health (REACH) Model and Medicare Shared Savings Program, be improved to increase SNF participation. Second, how can models better incorporate episodic-based payment within broader ACO arrangements. Ultimately, the roundtable recommendations were focused within five key areas: alignment/participation options for beneficiaries residing in LTC facilities, financial methodology, quality measurement, data, and future model concepts.
“If CMS is to achieve its goal of having all Medicare beneficiaries in an accountable care relationship by 2030, then it must take steps to better include provider types less represented in ACOs, including SNFs,” NAACOS Senior Vice President of Government AffairsAisha Pittman said. “We hope our recommendations spark attention to this area because patients served by LTPAC providers deserve the higher quality, lower cost care we know value-based care delivers.”
The white paper with specific recommendations included is available online. AHCA/NCAL and NAACOS plan to continue collaboration on this effort to support a clear path forward in which ACO models better incorporate LTPAC providers.
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ABOUT AHCA/NCAL
The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) represents more than 14,000 non-profit and proprietary skilled nursing centers, assisted living communities, sub-acute centers, and homes for individuals with intellectual and development disabilities. By delivering solutions for quality care, AHCA/NCAL aims to improve the lives of the millions of frail, elderly and individuals with disabilities who receive long term or post-acute care in our member facilities each day. For more information, please visit www.ahcancal.org.
ABOUT NAACOS
The National Association of ACOs (NAACOS) represents more than 9 million beneficiary lives through Medicare’s population health-focused payment and delivery models. NAACOS is a member-led and member-owned nonprofit of more than 430 ACOs in Medicare, Medicaid, and commercial insurance working on behalf of health systems and physician provider organizations across the nation to improve quality of care for patients and reduce health care cost.