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2023 WRAP UP AND 2024 OUTLOOK
NAACOS had an exceptional year in 2023, thanks to the commitment and collaboration of its members and partners. Together, we achieved remarkable success and forged new relationships that opened up more opportunities for our members.
Highlights of our 2023 accomplishments include:
- Member Satisfaction. 92 percent of members are satisfied with the support NAACOS provides through resources and educational content.
- ACO Growth. NAACOS continues to be the association of choice for ACOs. In 2023 membership increased from 402 to 430 ACOs, collectively serving over 9 million beneficiaries.
- Largest Conference to Date. Our conferences are no longer a secret, and thanks to the incredible educational and networking opportunities they offer, we had a record-breaking 732 attendees onsite at the Fall 2023 Conference, making it our largest conference to date.
- Expanded Education. We are continually striving to meet the educational needs of our members, and in 2023, we expanded our educational offerings by increasing the number of webinars, learning discussions, discovery calls, learning labs, and affinity groups. We are grateful to all the volunteers who presented and facilitated educational content through various platforms.
- Advocacy Success. NAACOS was hard at work communicating the value of ACOs with many congressional offices, advocating for changes to enhance ACOs models, and educating members on updates from CMS. Our 2023 wins included:
- Expanded Capitol Hill Advocacy
- 123 in-person meetings, 42 virtual meetings with congressional offices
- Introduction of the Value in Healthcare Act in the House and Senate
- Senate Finance and House Energy and Commerce Committees vote on legislation to extend advanced alternative payment model (APM) incentives
- Invited to testify before the House Energy and Commerce Committee as part of its oversight of the Medicare Access and CHIP Reauthorization Act of 2015
- Spreading importance of ACOs and VBC through Thought Leadership
- Alliance for Value Based Patient Care published 12 patient success stories and continued campaign to extend APM incentives with geotargeted ads
- Launched and published nine NAACOS blogs
- Successful advocacy with the administration, including:
- Favorable policy changes to MSSP such as new Medicare clinical quality measure (CQM) reporting option for ACOs
- Changes to ACO REACH including health equity benchmarks, risk corridors for retrospective trend adjustment, blended introduction of new risk model
- Continued engagement with CMS on Enhanced +, primary care hybrid payment within MSSP, and benchmark improvements
- Convened members through Advocacy and Learning Collaboratives to develop detailed policy recommendations regarding patient engagement, eCQM implementation, benchmarks and adjusting models to better serve rural and underserved communities
2024 Outlook
The success of 2023 has given us a better understanding of the needs of our members, and we are excited to build on that in 2024. Here are some of the things we have planned for the year ahead:
- Boot Camps: We are kicking off 2024 with a deep dive into accountable care. Our 2024 Boot Camps will have two comprehensive tracks designed to equip our members with the tools they need and provide a space for deeper conversations in clinical operations and data & analytics. Are you registered?
- Membership Growth: We will continue to develop programs and resources to attract new ACOs. In 2023, we explored new partnerships and marketing efforts to increase awareness of our ACO community, resources, and educational content. In 2024, we plan to continue expanding our membership.
- Strategic Plan: At the 2023 Meeting of Members event, we unveiled our newly crafted strategic plan. In 2024, we will start to unpack what is needed to execute each phase of the plan.
- Advocacy. We have a robust set of priorities to pursue this year in support of ACO growth and success:
- Improvements to the ACO REACH Model
- MSSP: Primary Care Prospective Payment Option and Higher/Full Risk Track
- More stable and accurate benchmarks (e.g., addressing ratchet)
- Expanding or improving risk arrangements with other payers
- Improving beneficiary outreach and quality reporting approaches
- Continuing incentives to join APMs
We want to extend a heartfelt thank you to our members and partners for their continued support and participation in NAACOS. We are excited about the possibilities that 2024 holds, and we look forward to working together to shape the future of accountable care.
ATTEND THE ONLY BOOT CAMPS FOR 2024, HOTEL DISCOUNTS EXTENDED
Join us February 8–9 at the Marriott Orlando Airport Lakeside hotel for our 2024 Boot Camp. We are featuring two concurrent boot camps that teach ACOs how to succeed in key functional areas. One focuses on data and analytics, sponsored by Wakely and Diagnostic Robotics, and the second on best practices for clinical operations, sponsored by Brilliant Care and iRhythm. Participants must register for one boot camp and may attend only that one. Daily lunches and a reception will be held jointly so all attendees can benefit from increased networking opportunities. The Marriott Orlando Airport Lakeside has extended the discounted rate for our participants. To receive the rate, you must call Richard Enderica at the Marriott directly 407-816-4026. The rate is only available for as long as rooms are available, so book NOW.
**This boot camp will only be offered for in-person participation. There is no virtual option. Boot camps are not open to business partners. Space is limited to 100 people per boot camp.**
NAACOS typically holds a winter and a summer boot camp but will not be holding a summer boot camp in 2024. Register now so you don’t miss out this year!
START THE NEW YEAR OFF RIGHT: REGISTER EARLY FOR SPRING CONFERENCE
Meet us at the Baltimore Hilton Inner Harbor on April 10–12 for the Spring 2024 Conference! The detailed agenda will feature leading health care experts and CMS officials sharing timely and essential information for ACOs. Registration is now open 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 (before February 23) and save!
Sponsor and exhibit opportunities for the Spring 2024 Conference are selling out! Reserve your space today!
DISCOVERY CALL: USING THE MSSP BENCHMARK TOOL TO ESTIMATE YE RESULTS
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. This year, there is an additional complexity due to the COVID PHE ending. Join us for this discovery call on March 7 from 2:00 pm to 3:00 pm ET, where you will hear from Andrew Webster, ASA, MAAA, chief actuary at Validate Health, who is an 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.
FIRST ROUND OF AFFINITY GROUPS START JANUARY 30
Affinity groups are a great way to engage in peer-to-peer discussion on role-based issues. There are three virtual sessions each year, and the first round for 2024 starts this month. If you have not already signed up for the affinity group or groups, the links are below. This is a member-only benefit and requires valid login to our website to sign up. Once signed up, you will receive a meeting link to add to your calendar. If you have already signed up, the link from the previous meeting will work to enter the session and you will receive meeting reminders.
Operations
January 30 from 3:00–4:00 pm ET
Participants include managers and others who oversee day-to-day aspects of running an ACO such as building provider networks, engaging patients, practice transformation, and implementing projects to achieve the ACO’s financial and strategic goals, etc.
Sign up for the Operations Affinity Group.
Quality
February 6 from 3:00–4:00 pm ET
Participants include managers and others who implement initiatives designed to improve, measure, and report the quality of care in an ACO, etc.
Sign up for the Quality Affinity Group.
Data and Analytics
February 13 from 3:00–4:00 pm ET
Participants include managers within ACOs who are responsible for integration, using data to analyze performance, creating and integrating data from sources like EMRs, claims and registries, etc.
Sign up for the Data and Analytics Affinity Group.
Executive
February 20 from 3:00–4:00 pm ET
Participants include CEOs, CFOs, Executive Directors, Chief Value Officers, and others who oversee the ACO’s finances, budget, strategy, contracting, etc.
Sign up for the Executive Affinity Group.
CMOs and Clinical Issues
February 27 from 3:00–4:00 pm ET
Participants include CMOs, CNOs, Pop Health Officers, and others who manage patient care, and clinical care redesign, etc.
Sign up for the Clinical Affinity Group.
Compliance and Legal Issues
Meets: March 5 from 3:00–4:00 pm ET
Participants include those who ACO leaders and staff members who deal with compliance documentation, operations, or events, as well as those who deal with ACO contracting with payers and participants.
Sign up for the Compliance and Legal Affinity Group.
NAACOS TO CO-HOST CONGRESSIONAL BRIEFING
NAACOS and our partners in the Alliance for Value-Based Patient Care are hosting an educational briefing for congressional staff during Health Care Value Week. The briefing will be held on Capitol Hill on January 30. Help us spread the word by inviting congressional staff in your delegation to attend. Please contact Robert Daley for more information.
JOIN NAACOS CALL ON FINDING FRAUDULENT CLAIMS
Registration is open for the NAACOS Discovery Call on potential durable medical equipment (DME) fraud within your ACO. NAACOS has heard from ACO members who have identified potential issues of fraud in their claims data, particularly around durable medical equipment. To better assist members, NAACOS is holding a call to discuss the issue with members. We’ll review best practices for alerting CMS and the HHS Inspector General along with what NAACOS is doing to help ACOs looking to have these claims removed from their performance year expenditures.
DECEMBER ACO REACH LEARNING DISCUSSION
Join NAACOS for its next ACO REACH Learning Discussion on January 19 at 12:00 pm ET. This month, we will be joined by staff of the CMS Innovation Center team that runs the ACO REACH Model. They’ll share lessons learned to date and be on hand to hear about key topics of interest to participants. 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!
NAACOS RECOMMENDS IMPROVEMENTS TO MSSP
In a letter sent to CMS, NAACOS highlighted that CMS must consider approaches that will maintain and expand existing ACOs in its rulemaking this year that will set new policies for 2025 and beyond. Overall, we ask that CMS consider the broader competitive landscape ACOs face: fee-for-service (FFS) remains a strong financial alternative and Medicare Advantage (MA) offers stronger opportunities for revenue and providing enhanced beneficiary services. To ensure that Medicare ACOs are a strong and viable option, CMS should:
- Recognize the fiscal realities of remaining in an alternative payment model (APM) and correct the benchmark ratchet.
- Leverage its authority to create strong nonfinancial incentives by removing burden from the quality reporting and beneficiary notification requirements.
- Support next generation innovation by offering primary care hybrid payment and an Enhanced Plus track.
While the Calendar Year (CY) 2025 Medicare Physician Fee Schedule proposed rule is not released until July, CMS will begin considering and drafting new policies now. NAACOS will continue to advocate for the policies outlined in the letter, and we encourage you to share these in your communications with CMS.
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CONGRESS REACHES AGREEMENT ON GOVERNMENT FUNDING
Congressional leaders have landed on a deal that will allow Congress to move forward with legislation to extend government funding. If passed, the new continuing resolution will fund the government through March 1 and March 8. The current funding deadlines are January 19 and February 2.
- March 1 for four appropriations bills: Agriculture, Rural Development, Food and Drug Administration, and Related Agencies; Energy and Water Development; Military Construction, Veterans Affairs, and Related Agencies; and Transportation, Housing and Urban Development, and Related Agencies.
- March 8 for the remaining eight appropriations bills: Commerce, Justice, Science, and Related Agencies; Defense; Financial Services and General Government; Homeland Security; Interior, Environment, and Related Agencies; Labor, Health and Human Services, Education, and Related Agencies; Legislative Branch; and State, Foreign Operations, and Related Programs. This includes health care provisions to delay disproportionate share (DHS) cuts, extend funding for the Teaching Health Center Graduate Medical Education program, the Community Health Center Fund, and the National Health Services Corps, and extend work geographic index floor.
Lawmakers are expected to vote on the bill by the end of the week. The extension of Medicare’s incentives for advanced APMs and physician payment updates are not included in the current funding bills. While we are pleased that an extension of these incentives remains a congressional priority, the cost of extending the incentives and the desire for a clean continuing resolution will continue to be our limiting factor. NAACOS will continue lobbying Congress for an extension. NAACOS, along with our congressional champions, will continue to advocate for the highest possible incentive payment for clinicians in advanced APMs. Contact Robert Daley for more information about how to ask your lawmakers to support an extension.
UPDATED MSSP BENEFICIARY NOTIFICATION TEMPLATES AVAILABLE
CMS has published updated templates for the required beneficiary notification and poster for PY 2024 in the “Marketing and Beneficiary Education Toolkit” within the ACO-MS. As a reminder, posters must be displayed in all ACO participant facilities (regardless of whether primary care services are provided in each facility). The standardized written notice and follow-up communication must be provided to beneficiaries once per five-year agreement period. For more information, see CMS’s guidance and FAQs.
MSSP PUBLIC REPORTING DEADLINE FEBRUARY 12
All MSSP ACOs must update their public reporting webpages with PY 2024 information by February 12. ACOs must use the PY 2024 Public Reporting Instructions and Template (Version 8) to update this information, found in the templates section of the program resources in the ACO-MS Knowledge Library tab. For ACOs receiving advanced investment payments (AIP), this includes the required public reporting of their use of AIP; refer to the new AIP section in the template for instructions on how to report AIP information. Updated PY 2024 public reporting instructions and templates are available for download and in the ACO-MS.
MSSP QUALITY REPORTING DEADLINE APRIL 1
Quality submissions for the 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. 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. CMS will hold CMS Web Interface support calls Wednesdays from 1:00-2:00pm ET on January 24, February 7, February 21 and March 6. Learn more about MSSP quality reporting requirements on our website. CMS also recently published a new quality data completeness resource for ACOs. Stay tuned for a NAACOS webinar on MSSP quality reporting.
FINAL NEXT GEN ACO EVALUATION FOUND MODEL SAVED MONEY
The Next Generation ACO Model, the precursor to today’s ACO REACH Model, generated an average of $270 million in gross savings in each of its six years, according to the final evaluation on the model released earlier this month. Importantly, evaluators did not find reductions in quality of care. The model ran from 2016 to 2021 and tested higher levels of risk and reward compared to MSSP. The Next Gen model was also associated with declines in hospital admissions, post-acute care, emergency department visits, and ambulatory visits. NAACOS congratulates participants for their success and hopes lessons learned from the model can be applied to other ACO programs. The two-page summary of the evaluation is available online.
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| WHAT WE’RE WATCHING: NEWS ABOUT ACOS AND HEALTH CARE |
MEDPAC VOTES ON PAYMENT RECOMMENDATIONS AND DISCUSSES MEDICARE ADVANTAGE
The Medicare Payment Advisory Commission (MedPAC) met last week to discuss payment recommendations that will be sent to Congress in March.
- Physicians and Hospitals— the commission will recommend a 1.3 percent payment update for physicians and an additional 1.5 percent for hospitals in 2025. The commission will also recommend establishing a safety-net add on payments for low-income patients and transitioning to redistributing disproportionate share hospital (DSH) and uncompensated payments through the Medicare safety-net index (MSNI).
- Medicare Advantage— the commission presented its annual status report for MA which highlighted that 52 percent of Medicare beneficiaries are now enrolled in private plans. The report also discussed coding issues and estimated that overspending on MA will increase to $88 billion in 2024. CMS is expected to release new 2025 payment proposals in the coming weeks.
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