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REGISTRATION IS OPEN FOR NAACOS FALL ADVOCACY SUMMIT AND HILL DAY
NAACOS will be hosting a two-day Fall Advocacy Summit and Hill Day on September 11 and 12. The Advocacy Summit and Hill Day is an opportunity for NAACOS members to meet with members of Congress and their staff. This year, the fall Hill Day is scheduled for September due to the congressional calendar prior to the election. Please note that this event is not in conjunction with the NAACOS Fall Conference on October 16-18. Space for the Advocacy Summit and Hill Day is limited to the first 40 registrants (limit of two attendees per ACO), so sign up today! Registration will close on July 12.
PATIENT STORIES FROM THE ALLIANCE FOR VALUE-BASED PATIENT CARE
Check out patient stories collected through the Alliance for Value-Based Patient Care. These stories demonstrate the power of value-based care and reasons why policymakers should support this work. We will continue highlighting patient stories. Submit any stories from your organization or contact David Pittman for more information.
Follow the Alliance on LinkedIn and Twitter.
HELP SHAPE NAACOS RESPONSE TO TEAM MODEL AND SENATE FINANCE WHITE PAPER
NAACOS Draft Comments on TEAM
CMS proposed the Transforming Episode Accountability Model (TEAM), a mandatory episode payment model in the Inpatient Prospective Payment System (IPPS) rule. If finalized, TEAM would hold hospitals accountable for costs for episodes for a 30-day period for 5 clinical episodes: lower extremity joint replacement; surgical hip/femur fracture treatment; major bowel procedure; spinal fusion; and coronary artery bypass graft.
NAACOS’ draft comments in response to this proposed model are now available, and we are accepting feedback through Friday, June 7. Please email feedback to Jennifer Gasperini. We encourage you to use all or portions of our comments in your own response. Comments are due to CMS by June 10th and can be submitted at regulations.gov.
In case you missed it, view our on-demand webinar, Unpacking CMS’ New Mandatory Bundled Payment Model, covering key model details for more information.
NAACOS Draft Comments on Senate MACRA Reform Efforts
On May 17, Senate Finance Committee Chairman Ron Wyden (D-OR) and Ranking Member Mike Crapo (R-ID) released a bipartisan white paper outlining the committee’s priorities for reforming Medicare’s physician payment system, which includes creating sustainable payment updates and incentives for alternative payment models (APMs).
NAACOS’ is sharing an early draft of our comments in response to this request for information. We are accepting feedback through Monday, June 10 and will be finalizing the letter with the NAACOS policy committee on June 13. Please email feedback to Robert Daley.
The committee is collecting stakeholder feedback until Friday, June 14, and NAACOS staff will be participating in a round table with Senate Finance Committee staff next week to discuss our recommendations.
CMS MA DATA COLLECTION AND TRANSPARENCY RFI COMMENT LETTER
NAACOS responded to CMS’s request for information on improving the collection and transparency of Medicare Advantage (MA) data. NAACOS’ comments reflect the need for (1) providers and stakeholders to have access to comprehensive MA data sets to promote program and payment transparency and (2) providers to have data and aligned approaches to support provider-led transformation in MA through value-based care arrangements. Thank you to everyone who chimed in with feedback. For any questions or follow-up comments, please email Diwen Chen.
LAWMAKERS LAY OUT SUMMER AGENDA
The House and Senate returned to Washington this week following the Memorial Day recess. With the clock ticking down to the August recess and fall mid-term elections, lawmakers remain busy working to outline agenda items that will likely be considered during the lame-duck session at the end of the year.
- The Senate Finance Committee is accepting stakeholder comments on its Medicare physician payment white paper until June 14. NAACOS will be submitting comments and meeting with committee staff to discuss our short-term and long-term recommendations to incentivize participation in value models.
- The House Appropriations Committee has begun drafting and considering Fiscal Year 2025 spending bills. Appropriations Committee Chairman Tom Cole (R-OK) plans for the House to begin voting on bills this summer.
- The House Energy and Commerce Oversight and Investigations Subcommittee held an oversight hearing on the 340B Drug Pricing Program. There is bipartisan interest in both the House and Senate to look at potential reforms to the program.
- A bipartisan group of House and Senate members plan to reintroduce legislation in the coming days to improve access to care for seniors enrolled in MA by streamlining the prior authorization process through an electronic program. NAACOS supports the legislation along with hundreds of other stakeholder organizations.
CMS RELEASES PC FLEX RFA WITH KEY MODEL DETAILS
Last week, CMS published the request for applications (RFA) and opened the model application portal for the ACO Primary Care Flex (PC Flex) Model, which will test primary care hybrid payments within the Medicare Shared Savings Program (MSSP) beginning January 1, 2025. In order to apply, ACOs must submit an MSSP application (as an initial, re-entering, or renewing/early renewing applicant) and a supplemental PC Flex application questionnaire. The MSSP application is open now through June 17 at 12:00pm ET. The PC Flex supplemental application must be submitted by August 1, 2024. CMS will host a model applications webinar on June 6 at 2-3:30pm ET. NAACOS’ recent webinar included considerations for the PC Flex model, and the slides and recording are available on-demand. A NAACOS member alert with additional model details is available. Stay tuned for additional NAACOS resources on the PC Flex model.
MSSP APPLICATION AND CHANGE REQUEST CYCLE DEADLINE APPROACHING
The deadline to apply to participate in the MSSP with an agreement beginning January 1, 2025 (as an initial, re-entering, renewing, or early renewing applicant) closes on June 17 at 12:00pm ET. This is also the deadline for currently participating ACOs to request changes for Performance Year 2025 through the annual change request cycle. Options ACOs may take during the change request cycle include changing participation options, modifying the ACO Participant List by adding and/or deleting participants, applying for a SNF 3-day Rule waiver and modifying SNF affiliates, and applying for a Beneficiary Incentive Program (BIP). Last week NAACOS hosted a webinar, “MSSP 2025 Application Insights” with tips and tricks for applicants. See the Application Toolkit & Change Request Cycle Resources for more details.
CMS PROPOSES MANDATORY KIDNEY TRANSPLANT MODEL
CMS has proposed a mandatory payment model to start in January 2025. The six-year Increasing Organ Transplant Access (IOTA) Model would assess hospitals on organ acceptance rate, survival rate, and other domains, including a health equity component. Eligible hospitals are those that conduct at least 11 transplants during a three-year baseline period. CMS estimates 90 of the more than 250 transplant hospitals in the country would be required to participate. The model would incorporate downside risk in 2026. Comments on the proposed model are due July 16. HHS’s fact sheet and press release are also available online.
EOM OPENS SECOND COHORT OF APPLICANTS
The CMS Innovation Center opened a solicitation of applicants for a second cohort of participants for the Enhancing Oncology Model (EOM). EOM seeks to drive transformation in oncology care by holding participants financially accountable for total cost of care for each attributed episode following a qualifying cancer therapy. The model is now scheduled to conclude in 2030. CMS also made changes to the model effective January 1, 2025, including extending the model by two years, making higher monthly payments for enhanced services (from $70 to $110 per member per month), and establishing a higher threshold for recoupment. Medicare-enrolled oncology physician groups are eligible to participate, and applications will be open from July 1 through September 16, 2024. For more information see the RFA and model website.
CMS MEDICARE CQM PATIENT LISTS
CMS has shared a list of all Medicare Clinical Quality Measures (Medicare CQMs) patients for MSSP ACOs in the quarterly informational reports delivered to ACOs in May. The Medicare CQM Report Template and Data Dictionary are also available in the ACO-MS (see templates section in the knowledge library). All ACOs will also receive a quarterly list of beneficiaries eligible for Medicare CQMs. ACOs can use the quarterly files to confirm measure denominator eligibility and collect measure data throughout the performance year. The final quarter four list will be the full list of ACO beneficiaries to complete Medicare CQM reporting. If you have any issues or concerns with these reports, please share with us at [email protected].
NEXT QUARTERLY CALL FOR PARTNERS ON JUNE 13
NAACOS Partners! Join us on June 13 at 12:00 pm ET for an engaging and informative call exclusively for Partner Circle, Business Partners, and Alliance Partners. NAACOS staff will provide an update on our latest initiatives and strategic priorities, as well as review upcoming sponsorship opportunities where you can showcase your brand. Don’t miss this chance to fully utilize the benefits of your NAACOS partnership. This meeting is open to Partners only.
PRACTICE TRANSFORMATION LEARNING LAB SERIES BEGINS JUNE 28
Whether you are new to value-based care payment models or have been in value for years, there are always new ways to improve patient outcomes as well as your bottom line. One is through practice transformation and care redesign. Understanding what others have tried, what is working well, and what isn’t can save you a lot of time and possibly money. For these reasons, NAACOS is presenting our next learning lab series on practice transformation. The new series begins on June 28 from 12:00 pm to 1:30 pm ET and will occur the Fourth Friday of each month through May 2025. These 90-minute monthly sessions will include topics such as practice assessment and redesign implementation, using data and analytics in a meaningful way, patient management services, and financial needs. A complete list of topics is at Learning Lab webpage. Register today and receive the link for the monthly calls starting June 28.
SUMMER VIRTUAL AFFINITY GROUPS RESUME JUNE 18
It’s time for the summer peer-to-peer discussion groups. If you have not previously signed up for one or more affinity groups, below is a list of options and the dates for the next two virtual meetings. If you have previously signed up, check to assure you have the appointments on your calendar, so you don’t miss the events. If you are missing the calendar appointment but know you have signed up previously, please use the Zoom link you received in previous emails to add to your calendar. You will use the same link you received for a previous meeting for the upcoming meetings. For example, the link for the 2024 Operations Affinity Groups will be the same link. If you have any questions, please reach out to Karen Fetterolf at [email protected]. We look forward to seeing you!
Operations
June 18 from 3:00–4:00 pm ET
October 29 from 3:00–4:00 pm ET
For 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.
Register for the Operations Affinity Group. |
Executive
July 16 from 3:00–4:00 pm ET
November 19 from 3:00–4:00 pm ET
For CEOs, CFOs, Executive Directors, Chief Value Officers, and others who oversee the ACO’s finances, budget, strategy, contracting, etc.
Register for the Executive Affinity Group. |
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Quality
June 25 from 3:00–4:00 pm ET
November 5 from 3:00–4:00 pm ET
For managers and others who implement initiatives designed to improve, measure, and report the quality of care in an ACO, etc.
Register for the Quality Affinity Group. |
CMO and Clinical
July 23 from 3:00–4:00 pm ET
December 3 from 3:00–4:00 pm ET
For CMOs, CNOs, Pop Health Officers, and others who manage patient care, and clinical care redesign, etc.
Register for the Clinical Affinity Group. |
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Data and Analytics
July 9 from 3:00–4:00 pm ET
November 12 from 3:00–4:00 pm ET
For 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.
Register for the Data and Analytics Affinity Group. |
Compliance and Legal
July 30 from 3:00–4:00 pm ET
December 10 from 3:00–4:00 pm ET
For 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.
Register for the Compliance and Legal Affinity Group. |
| WHAT WE’RE WATCHING: NEWS ABOUT ACOS AND HEALTH CARE |
- The release of a proposed rule that will address suspected durable medical equipment (DME) fraud. Last week, CMS submitted a proposed rule to the Office of Management and Budget for clearance titled “Mitigating the Impact of Anomalous Increases in Billing on Medicare Shared Savings Program Financial Calculations.” This week, NAACOS has several meetings with CMS to discuss our stakeholder letter on proposed solutions.
- The Government Accountability Office (GAO) announced new appointments to the Medicare Payment Advisory Commission (MedPAC). The commission will release its June report to Congress in the coming weeks.
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