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NAACOS MACRA 2.0 LONG-TERM APM REFORM CONCEPTS
As congressional fatigue with short-term physician payment and alternative payment model (APM) fixes grows, lawmakers in both the House and Senate are beginning to hold discussions about the need to advance longer-term solutions to physician payments and driving the transition to value. NAACOS is encouraged by these discussions about reforming the Medicare Access and CHIP Reauthorization Act (MACRA). NAACOS has been working with the board and policy committee on potential solutions for future incentives. We encourage members to review these draft reform concepts and provide our advocacy team with feedback at [email protected].
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LAST CALL: REGISTRATION FOR THE SPRING HILL DAY CLOSES TOMORROW
Want to make your voice heard in Washington and advocate for policies that benefit ACOs? Join the NAACOS Spring Hill Day on Wednesday, April 10, in conjunction with our spring conference. NAACOS staff will coordinate travel between Baltimore and Washington, D.C., for those attending the conference. Registration closes tomorrow, March 1. If you have questions, contact Robert Daley.
GET INVOLVED IN NAACOS ADVOCACY AND LEARNING COLLABORATIVES
NAACOS convenes forums for members to share best practices and design policy solutions on key topics across value. These monthly or quarterly forums are designed to take a deeper dive into operational and policy solutions that members are facing. Below are the current collaboratives, reach out to the advocacy team member if you’re interested in joining.
NAACOS AND AHCA PARTNER ON ENCOURAGING POST-ACUTE CARE PARTICIPATION IN ACOS
In a new paper, NAACOS and the American Health Care Association/National Center for Assisted Living (AHCA/NCAL) put forth several recommendations that would increase the participation of long-term and post-acute care (LTPAC) providers in accountable care organizations (ACOs). The paper provides recommendations on how current models can be adapted to increase SNF participation, specifically addressing alignment, participation options, financial methodology, quality measurement, and data. Additionally, the paper discusses future model concepts for incorporating episode-based payment for long-term care into total cost of care models.
NAACOS SCORES MULTIPLE POSITIVE CHANGES IN ACO REACH
The Center for Medicare and Medicaid Innovation (CMMI) recently announced two changes to ACO REACH which NAACOS raised with members during a REACH Advocacy and Learning Collaborative:
- CMMI will count G2025 as meeting the “timely follow-up” measure. Since some safety-net providers bill for G2025, it not being counted in the measure was problematic.
- Updated guidance on health equity data reporting will allow for use of third-party vendors. Not allowing such vendors would be problematic for ACOs given the volume of work needed to collect and report such data.
PATIENT EXPERIENCE PROJECT RECRUITMENT
The American Heart Association is leading a project to understand and convey the benefits of person-centered value-based care (VBC) for patients, caregivers, and care team members. Learnings will help build a foundation for educating the broader consumer and patient advocacy community, policymakers, and others about the benefits of ACOs and VBC.
NAACOS is participating on the expert panel for this project and aiding in recruitment of patients, caregivers, and care team members in risk-based APMs for key informant interviews. If you have an interest in this work, please contact Alyssa Neumann to learn more and get connected with the project lead.
NAACOS ENGAGEMENT ROUNDUP
- The Alliance for Value-Based Patient Care, of which NAACOS is a founding member, released its latest issue brief, which focuses on the patient benefits from value-based care. The Alliance works to advance value-based care through joint advocacy, shared education, and strategic communications. Follow the Alliance on LinkedIn and Twitter.
- NAACOS will participate on the National Quality Forum (NQF) Leadership Consortium, a forum of experts from public and private sectors across all aspects of health care to consider some of the most critical challenges the industry faces today and identify effective strategies to address these challenges. Learn more on the NQF website.
CONGRESS APPROACHES FIRST GOVERNMENT FUNDING DEADLINE
Congressional leaders reached a tentative deal to provide another-short term extension of funding to allow additional time to finalize a full year government funding bill.
- The funding deadline for Food and Drug Administration (FDA) and Veterans Affairs (VA) programs will now be Friday, March 8.
- The funding deadline for Health and Human Services (HHS) programs will now be Friday, March 22.
- Congress also needs to address a series of health care programs that expired at the end of 2023. This includes the advanced APM incentive payments and the reimbursement cuts to the Medicare physician fee schedule.
Contact your lawmakers today to ask them to support ACOs by extending the advanced APM incentives. Visit the NAACOS Congressional priorities page for a draft message to send lawmakers and contact Robert Daley for additional assistance.
SENATE BUDGET COMMITTEE WILL HOLD HEARING ON PRIMARY CARE
The Senate Budget Committee will hold a hearing next Wednesday to discuss ways to improve Medicare payments for primary care and drive more participation in value-based care. NAACOS board member, Dr. Bob Rauner has been invited to testify at the hearing. NAACOS will also submit a statement for the hearing record which will be available online next week.
CMS PUBLISHED DETAILS ON AHEAD MODEL, HOSPITAL BUDGETS AND ACO OVERLAP
The States AHEAD Model is a state-focused CMMI model that will test hospital-global budgets and hybrid payment for primary care. Recently, CMMI published detailed specifications on how the model will set global budgets for hospitals and a factsheet on model overlap. In summary, the overlap with AHEAD will be permitted for MSSP and REACH, ACOs will be held accountable to hospital spending in the model.
In case you missed it, NAACOS hosted a webinar on AHEAD last year. Stay tuned for additional resources and information on the overlap considerations.
MSSP QUALITY REPORTING DEADLINE IS APRIL 1
Quality submissions for the Medicare Shared Savings Program (MSSP) are due April 1, 2024, by 8:00 pm ET. Any data contained within the CMS Web Interface as of this date and time will be considered a final submission. CMS has resources available:
- Final CMS Web Interface support call March 6 from 1:00 to 2:00 pm ET
- Quality data completeness for ACOs
- The Quality Payment Program resource library contains a number of resources for quality reporting of electronic clinical quality measures (eCQMs), MIPS CQMs, and Web Interface measures including FAQs
NAACOS is also here to help; learn more about MSSP quality reporting requirements.
CMS CONFIRMED FOR OPENING PLENARY! EARLY REGISTRATION DEADLINE FRIDAY
Meet us at the Baltimore Hilton Inner Harbor on April 10-12 for the Spring 2024 Conference! The detailed agenda features leading health care experts and CMS officials sharing timely and essential information for ACOs. Our opening plenary will feature a fireside chat with:
- Liz Fowler, deputy administrator and director of CMMI
- Dora Hughes, acting chief medical officer and director for CCSQ
- Meena Seshamani, deputy administrator and director, Center for Medicare
Pre-conference workshops will be held concurrently on Wednesday, April 10 from 1:00–5:00 pm ET. These workshops require separate registration from the main meeting. There will be three concurrent workshops featuring topics on:
- Primary Care Transformation
- Your Multi-payer ACO Roadmap: Strategic and Operational Synergy and Success
- Care Needs and Contracting for Unique Populations
Early registration ends Friday, March 1 for both in-person and virtual participation. Member ACOs get an additional discount when they register groups of individuals. More information can be found on our website. Register early and save!
LAST WEEK TO SIGN UP FOR THE NAACOS MSSP BENCHMARKING DISCOVERY CALL
With the upcoming release of the QEXPU for 2023 Q4, MSSP ACOs shift their attention to how they can forecast their Performance Year (PY) 2023 performance. Historically, many ACOs have had questions about how to best use the CMS Benchmark Estimator Tool and why the calculations are often so different from the final settlement. Join us for this discovery call on March 7 from 2:00 to 3:00 pm ET, where you will hear from Andrew Webster, ASA, MAAA, chief actuary at Validate Health, and actuarial advisor to NAACOS, on using the CMS Benchmark tool for your ACO. This discovery call is intended to be an interactive discussion to cover the basics of applying your Q4 files to this tool, the sensitivity of forecast accuracy to unknown variations and errors in inputs, and methods to improve forecast usefulness. After a brief presentation, participants will have the opportunity to discuss using the tool and how it has worked in predicting their year-end (YE) results. Register now to join this group call.
NAACOS UPDATES 2024 MSSP AND REACH COMPLIANCE MANUALS
NAACOS has partnered with Wilems Resource Group to offer MSSP and REACH ACOs Compliance Manuals with a robust set of policies and procedures that your organization can customize to meet individual needs. Why should you purchase the manual? ACOs are required to meet a large number of state and federal regulatory requirements, including health care fraud and abuse laws, privacy requirements, and the specific requirements of CMS. These manuals include the necessary tools 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. Purchase or renew your subscription today! Members can also view the recordings of two recent webinars that explain how to use the manuals.
| WHAT WE’RE WATCHING: NEWS ABOUT ACOS AND HEALTH CARE |
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