NAACOS PUBLISHES PATIENT ENGAGEMENT RESOURCES
This week, NAACOS published two new resources on ACO patient engagement that were developed by NAACOS’ patient engagement workgroup and incorporate feedback from key patient and consumer advocacy groups.
Additionally, NAACOS published the results from a recent survey on ACO patient engagement efforts. Survey responses show that ACOs have diverse strategies for engaging patients and are implementing innovative approaches to incorporate patient perspectives into their communications, population health initiatives, and processes. A full summary of the results and a companion chartbook are available. To learn more about NAACOS’ patient engagement work, contact Alyssa Neumann.
NEW SPEAKER TAKES THE GAVEL
House Republicans elected Rep. Mike Johnson (R-LA) as the new Speaker of the House of Representatives. His election came after three weeks of disagreement among House Republicans following the removal of Rep. Kevin McCarthy (R-CA). Johnson is serving his fourth term in Congress and has had a lower national profile. Johnson is expected to be much more conservative than previous Republican leaders as he previously served as Chair of the House Republican Study Committee, the largest group of conservatives in the House.
Since being elected Speaker, Johnson has outlined an aggressive agenda that includes plans for passing all 12 appropriations bills with a focus on reducing federal government spending. It’s expected that the House will pass another short-term funding bill before the current continuing resolution (CR) ends Friday, November 17. An extension of funds is expected to last through January or April, while the House works to finish passing spending bills. Negotiations leading up to the November 17 federal funding deadline will be instructive about the prospects for getting other legislation completed, including a potential end-of-the-year health package.
While the new House leadership may affect our advocacy strategy, it will not change our primary legislative objective, which includes an extension of Medicare’s incentives for advanced APMs. As Congress begins working to identify end-of-year priorities, we encourage you to contact your congressional delegations asking them to support an extension of Medicare’s 5 percent advanced APM incentive. Contact Robert Daley if you need assistance with outreach to your representatives.
DIRECT CONTRACTING SAVED $870 MILLION IN 2022
The CMS Innovation Center released financial and quality performance results on the Global and Professional Direct Contracting Model in 2022. (The model is now called ACO REACH.) While serving 1.8 million beneficiaries, Direct Contracting Entities (DCEs) generated $870 million in gross savings and $484 million after accounting for shared savings and losses and discounts. This is a seven-fold increase in gross savings compared to 2021. Quality scores across all DCEs averaged more than 99 percent.
Including the 2 percent discount, High Needs, New Entrant, and Standard DCEs achieved net savings rates of 9.8 percent, 4.4 percent, and 3.0 percent respectively. Overall, 76 percent of DCEs earned shared savings for a total of $668 million, and 23 percent incurred losses, which totaled $481 million. NAACOS issued a press release on the results. More information can be found on CMS’s website. NAACOS congratulates DCEs on their hard work and good performance. We look forward to continuing to work with our members to achieve success in the ACO REACH model.
Related, the CMS Innovation Center also released the formal evaluation of the model from its first year, 2021. While the evaluation found no impact on gross or net savings to Medicare, 2021 was the first year, a nine-month performance year, and had its fewest number of participants.
BPCI ADVANCED DEADLINE APPROACHES
Applicants joining the BPCI Advanced model in 2024, as well as active model participants seeking to continue their participation must submit a signed participation agreement by December 4 at 12:00 pm ET via the participant portal. In response to stakeholder feedback, CMS extended the period for data review to at least eight weeks after distribution of baseline data and preliminary target prices. Applicants will then be required to submit a signed participation agreement and completed participant profile by December 4. For a full timeline of the application process and additional information, visit the Innovation Center website.
CMS ISSUES PROPOSED INFORMATION BLOCKING RULE
CMS recently issued a proposed rule implementing provisions of the 21st Century Cures Act to create disincentives for health care providers committing information blocking. In the rule, CMS proposes:
- ACOs who are health care providers as well as ACO providers/suppliers who are engaged in information blocking would be removed from or denied approval to participate in MSSP.
- Merit-Based Incentive Payment System (MIPS) eligible clinicians who are health care providers and engaged in information blocking would receive a zero for their Promoting Interoperability category contributing to their overall MIPS score.
- Hospitals and Critical Access Hospitals (CAHs) involved in information blocking would not meet meaningful use criteria and therefore receive a reduction in payment.
NAACOS will provide a more detailed analysis of the proposed rule in the coming weeks. Share any feedback regarding how this proposal will affect your ACO by emailing [email protected] to help inform our comments.
EXECUTIVE ORDER ON AI
President Biden issued an Executive Order on the safe, secure, and trustworthy development of artificial intelligence (AI) on October 30. The order is focused on development of best practices and guidelines for use and evaluation of AI. Healthcare provisions of the order include:
- Establish an HHS AI task force that will develop policies, frameworks, and regulations on the deployment and use of AI.
- Encourage AI innovation by a wide range of health care technology developers through grants and private sector collaboration.
- Develop AI systems that improve quality of veteran’s health care.
- Determine how federal nondiscrimination laws for providers that receive federal funds apply to AI.
- Develop a strategy to evaluate performance of AI-enabled health care tools.
NAACOS QUARTERLY PARTNER CALL
Join us on December 7 at 11:00 a.m. ET for an engaging and informative call for NAACOS Business Partners, where you’ll gain valuable insights and updates on our latest initiatives. Connect with fellow partners, industry experts, and our dedicated team to explore collaboration opportunities and stay ahead of the curve. Don’t miss this chance to maximize the benefits of your partnership and shape the future together. Register today! This meeting is only open to Partners. Register Now!
MEDICAID LEARNING LAB NOVEMBER 3
If you have an interest in Medicaid topics, register for the next meeting of the Medicaid Learning Lab, tomorrow November 3 from 2:00 to 3:30 pm ET. Professor Rita Landgraf at University of Delaware’s College of Health Sciences will present the “Transformation of Health and the Healthcare System from Policy Translated into Practice.” In addition, the session will explore how the public funded system via Medicaid can advance equity in health beyond a traditional clinical care approach. Items of interest for this forum include Medicaid contracting with states or MCOs, population health management services, patient engagement, provider engagement and service best practices including primary care and specialty provider collaboration with hospitals, post-acute and community services to support population health and SDOH care needs. The final meeting on December 1 will include Art Jones, MD, one of the founders of Medical Home Network (MHN) ACO and continues to serve as its Chief Medical Officer, who will present his experiences in value-based care over the past two decades. Sign up today!
WATCH NAACOS’ WEBINAR ON MAKING CARE PRIMARY
Last week, NAACOS hosted a public webinar on the new Making Care Primary (MCP) model, discussing model details, tips for a successful application, and insights for the transition to accountable care. The slides and recording are available. Additionally, CMS has since published a step-by-step application manual for MCP applicants. The manual includes all application questions, instructions for completion, as well as screenshots of the application portal for ease of use. The application portal is open now through November 30 and you can access all of the model details and CMS resources on the MCP webpage.
AWV LEARNING LAB MEETS MONTHLY
NAACOS will hold monthly Annual Wellness Visit (AWV) Learning Lab sessions on the third Thursday of each month from 2:00 to 3:30 pm ET through March 2024. Our next AWV Learning Lab meeting will occur on November 16 and focus on structuring electronic health records (EHR) for successful documentation of billing requirements and care planning. Kevin McNeill, M.D., Lehigh Valley Health Network ACO, along with Carol Ann Hudson from Lifepoint Health will present on this topic. In addition, we are gathering some AWV EHR templates for our members to use as a guide for setting up their own templates. NAACOS Member ACOs can register here to join the AWV Learning Labs. The December meeting will include information on staffing models and engaging providers in AWV activities and will feature Brandy Smuzeski, LMSW, Medical Advantage Group. While this six-month series began October 19, you can find the recording and materials on the NAACOS website. You must log on to access the content.
VIRTUAL AFFINITY GROUPS: FALL EDITION UNDERWAY!
There is still time to sign up and join the remaining affinity group meetings scheduled for 2023. These virtual sessions are currently held three times a year between conferences with the dates noted below. Once you sign up, please add the zoom link to your calendar on the corresponding dates and times for each group.
Quality
November 7 from 3:00 to 4:00 pm ET
Participants should 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
November 14 from 3:00 to 4:00 pm ET
Participants should 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.
CMO and Clinical Issues
Meets: November 28 from 3:00 to 4:00 pm ET
Participants should 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
December 5 from 3:00 to 4:00 pm ET
Participants should 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
Executive
December 12 from 3:00 to 4:00 pm ET
Participants should 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
| WHAT WE’RE WATCHING: NEWS ABOUT ACOS AND HEALTH CARE |
- This Health Affairs Forefront piece makes the case for a “Social ACO” in Medicaid.
- CMS authored an article detailing its ongoing strategy to promote equity in quality and value programs in JAMA. It is calling the approach, Rewarding Excellence for Underserved Populations (REUP).
- The Health Care Payment Learning and Action Network (HCP-LAN) hosted the annual LAN Summit and released the 2023 APM Measurement Effort this week. The 2023 APM Measurement Effort assesses 2022 APM participation across payer groups and found that 24.5 percent of payments flowed through two-sided risk APMs in 2022, up from 19.6 percent in 2021. The largest growth between 2021–2022 was in traditional Medicare, with payments through two-sided risk APMs increasing from 24 percent in 2021 to 30.2 percent in 2022.
- A new survey from the American Medical Association found 60 percent of physicians are in a practice that operates in an ACO, up from 58 percent last year and 44 percent in 2016.
- The Office of the National Coordinator for Health Information Technology (ONC) issued a report on use of patient portals. In 2020, ONC’s Cures Act Final Rule increased patient and provider access to health-related data, specifically through health IT developer adoption of secure standardized application programming interfaces (APIs) that make this information more widely available across smartphone apps. The API requirements have been rolled out to health care providers and enable patients to electronically access their health information using apps. This report analyzes data from the 2022 Health Information National Trends Survey to assess progress in patient access. It also shares details on methods and frequency of individuals’ access and use of online access and patient portals.
- ONC submitted a health information technology (HIT) focused final rule for review at the Office of Management and Budget (OMB). The proposed rule was released in April and covered a range of HIT topics including modifications to information blocking requirements and implementing certain certification requirements for HIT developers as well as implementing Version 3 of the United States Core Data for Interoperability (USCDI).
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