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NAACOS COMMENTS ON CONGRESSIONAL HEARING ON HEALTH CARE COSTS
The House Energy and Commerce Health Subcommittee recently held a hearing discussing health care spending. During the hearing lawmakers discussed addressing physician payment cuts and the need to invest in primary care. Lawmakers also focused on increasing transparency in health care, which included site neutrality and Medicare Advantage quality and overpayments. NAACOS submitted a statement highlighting how policymakers can build on the current success of ACOs.
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UPDATE ON NAACOS’ ADVOCACY AROUND THE DME ISSUE
NAACOS continues to raise the importance of stopping potential fraud in catheter claims. We’ve provided data to the New York Times, Washington Post and others on the alarming spike in Medicare billing for catheters. We have met with offices on Capitol Hill to demonstrate how ACOs are critical to protecting Medicare from fraud, waste, and abuse and to emphasize that Congress must continue to incent adoption of alternative payment models (APMs). Additionally, CMS leadership tells us that they’re making it a high priority to ensure ACOs are not penalized by fraudulent activity. We will continue to keep you updated as we hear from CMS and work with the agency to develop long-term solutions to streamline fraud identification and mitigation.
What can you do? NAACOS reminds its members that you’re obligated to report suspected fraud to the HHS Inspector General. Feel free to reiterate our request that ACOs not be held responsible for fraudulent claims and that the fraud reporting process needs to be improved.
FEBRUARY ACO REACH LEARNING DISCUSSION
Join NAACOS for its next ACO REACH Learning Discussion on February 16 at 12:00 pm ET. This month, we will discuss health equity data reporting requirements. Reporting is due next month, and we’ll go deeper into trends people are seeing, issues they’re encountering, and best practices. These monthly calls offer a chance to connect with peers about important topics related to the model. If you’re interested and not already signed up, register now!
LAWMAKERS CONTINUE WORK ON HEALTH PRIORITIES
While Rep. Cathy McMorris Rodgers (R-WA), the Chair of the House Energy and Commerce Committee, recently announced that she will not seek reelection in 2024, lawmakers are still busy working to address a long list of health care priorities.
- APM Bonus Extension—Congressional leaders are currently negotiating a path forward to fund the government and extend expired health care programs, including the advanced APM incentive payment. We need your help to call on lawmakers to support ACOs by extending these incentives! Visit our congressional priorities page for a draft message to send lawmakers and contact Robert Daley for additional assistance.
- MACRA Working Group—A bipartisan group of Senators announced the creation of a working group that will focus on addressing Medicare physician payment issues, including updating the Medicare Accesses and CHIP Reauthorization Act (MACRA).
- CBO Scoring—The House Budget Committee approved legislation that would allow Congress to more easily request Congressional Budget Office (CBO) estimates of preventive health initiatives beyond the customary 10-year budget window. NAACOS is encouraged that lawmakers are looking at ways to reform CBO’s scoring as this change would allow them to more accurately capture the potential long-term savings from health care programs.
- Hospital at Home—Senators Tom Carper (D-DE) and Marco Rubio (R-FL) introduced legislation to extend Medicare’s hospital at home program, which is scheduled to expire at the end of 2024.
- Artificial Intelligence—The Senate Finance Committee held a hearing to discuss AI in health care. The Chairman and Ranking Member of the committee signaled they are interested in working on legislation aimed at improving oversight of the technology in Medicare and Medicaid. There was also discussion about the role AI could play to improve value-based payment models.
CMS TO HOLD AI IN QUALITY MEASUREMENT EVENT
CMS will host a webinar on February 28 at 2:00 pm ET to discuss AI in quality measurement. The webinar will review how the Coalition for Health AI is working to define core principles to evaluate, monitor, and report on health AI systems, as well as how AI may inform the development and evaluation of quality measures.
MEDICARE SHADOW BUNDLES COMING FOR MSSP AND ACO REACH
CMS is now beginning to share information on shadow bundles. ACOs should expect to receive several files including an Acute Care Hospital (ACH) benchmark price file, an episode-level file with details about each bundle that could be triggered by your assigned beneficiaries, a file with all the claims that were used to build the episode-level file, and an ACO shadow bundle summary report. Institute for Accountable Care staff have worked with Medicare bundled payment data since 2012. If you would like to talk with us about how to use the shadow bundle data to find opportunities to improve efficiency, please contact Rob Mechanic or Jen Perloff.
HHS FINALIZES PART TWO OF SUBSTANCE ABUSE RULE
HHS recently finalized a rule that aims to make it easier to share patient records with substance abuse and addiction treatment information. Patients can now grant a single consent for the sharing of this information for treatment, payment, and health care operations. NAACOS commented on the proposed rule last year. We are reviewing the recent final rule and will update members on important changes. A fact sheet is available online.
CMS LAUNCHES VALUE-BASED CARE SPOTLIGHT WEBPAGE
CMS launched a new webpage dedicated to helping patients and stakeholders better understand value-based care. Dubbed “Value-Based Care Spotlight” the site features stories and resources tailored to patients and providers. CMS says it’ll update the site regularly. We encourage members to refer to it to help increase the understanding of value-based care.
EARLY REGISTRATION ENDS NEXT WEEK FOR SPRING 2024 CONFERENCE!
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. Pre-conference workshops provide an opportunity to gain a deeper understanding of critical operational challenges for ACOs, and three 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 and will cover these topics:
- Primary Care Transformation
- Your Multipayer ACO Roadmap: Strategic and Operational Synergy and Success
- Care Needs and Contracting for Unique Populations
Early registration ends next week 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!
DO YOU KNOW HOW TO FORECAST WITH YOUR MSSP Q4 FILES?
NAACOS will hold a discovery call to help ACOs utilize the MSSP Q4 files and the CMS benchmark estimator tool for forecasting 2023 year-end results. Join us on March 7 at 2:00 pm ET with Andrew Webster, ASA, MAAA, Chief Actuary at Validate Health and actuarial advisor to NAACOS. During this Zoom call, we will cover the basics of applying your Q4 files to this tool, sensitivity of forecast accuracy to input value variations, considerations for the end of the COVID PHE, and methods to improve forecast usefulness. After a brief presentation, we will have an interactive discussion, where attendees can share their own experience and challenges with using the tool as well as pick up tips from peers. Sign-up today to attend!
DON’T MISS THE LAST FEW VIRTUAL AFFINITY GROUPS BEFORE SUMMER
Don’t miss the final three virtual affinity group sessions for this winter. The remaining peer-to-peer affinity groups are Executive, Clinical, and Compliance and Legal. Sign-up for any of these groups that align to your ACO role. Once you have signed up, you will receive the Zoom log-in for these virtual meetings, which you must add to your own calendar. We will send reminders four weeks before each session. If you register after this, you will not be sent a reminder appointment. Not registered yet? Use the links found on our affinity group webpage We hope to see you there!
TODAY’S AWV LEARNING LAB SESSION TACKLES THE DATA
Are you signed up for the Annual Wellness Visit (AWV) learning lab series? Be sure to tune into this month’s session today (February 15) from 2:00 pm to 3:30 pm ET to hear how two ACOs utilized their AWV data. You will hear from BJC Healthcare’s Karen Shakiba, Program Director, ACO Operations, and Ly Mettlach, Lead Data Analytic Analyst, as well as Morgan Power, Director of Business Intelligence, Think ACO founding member, and a third-generation pharmacist, who will provide an overview of historical trends, data reporting options and workflows, as well as utilizing datasets, issues, and tools used to make the most of their AWV data. Not registered yet? You still have time to participate in the last two sessions and watch the recordings of previous sessions on the NAACOS AWV Learning Lab webpage.
| WHAT WE’RE WATCHING: NEWS ABOUT ACOS AND HEALTH CARE |
- In Health Affairs Forefront, authors explore how accountable care can support rural home-based primary care providers through payment and delivery flexibilities.
- In RevCycleIntelligence, primary care experts discuss barriers to value-based payment in primary care and key strategies to overcome those barriers.
- The CMS Innovation Center released results on the End Stage Renal Disease (ESRD) Treatment Choices Model from Measurement Year 3.
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