Spring 2023 Conference Agenda
May 3–5
Hilton Baltimore Inner Harbor

Sponsored Breakfast: Using Advanced Analytics to Pinpoint Cohort-Specific Improvement Opportunities 
Speakers: David Clain and Josh Gray, HDAI, David Klebonis, Palm Beach ACO

To succeed financially, ACOs must improve their performance - relative to both their own baseline metrics and those of other ACOs – year after year. As low hanging fruit is harvested, clearing a higher bar becomes progressively challenging. This session will include ACO leaders who will share how they have used advanced analytics to pinpoint areas for enhancing their performance. The key to their success is identifying gaps that lend themselves to focused and actionable interventions. They will present the results of their assessment for five distinct segments – low risk, risking risk, complex, transitional, and advanced illness patient cohorts.

Sponsored by Health Data Analytics Institute

Sponsored Breakfast: Care Coordination: The Next Level in the Post-Acute Network Journey
Speaker: Phyllis Wojtusik, Real Time Medical Systems  

This session will explore care coordination strategies that bring post-acute network (PAN) collaboration to the next level. We’ll discuss how ACOs can build trust that results in faster, more confident care decisions made by SNFs who are apprehensive in asking for clinical guidance when needed. Clinical experts will share how to further enhance collaboration with the use of care coordinators dedicated specifically to the post-acute segment and illustrate how live post-acute analytics helps manage this effort. Through first-hand experiences we’ll demonstrate how these dedicated care coordinators will build trusting relationships with SNF clinical teams to deliver effective care transitions, establish standard clinical pathways, monitor high-risk patients, lower length of stays, reduce readmissions, and increase network referral compliance.

Sponsored by Real Time Medical Systems

Sponsored Breakfast: New Evidence-Based Model for Enhanced Care Coordination With Remote Monitoring; Improving Medication Adherence and Outcomes in Higher Risk Population
Speakers: Fred Taweel, Privia Medical Group, Mid Atlantic; Alisha Thornton, Brilliant Care

Privia Health, one of nation’s most successful ACO networks, partnered with Brilliant Care to design a care management solution leveraging RPM for meaningful clinical improvements in hypertension and diabetes care. The model is a user-friendly experience for patients and providers alike; specifically focused to improve medication adherence, patient outcomes and lower total cost of care. The collaborative results solve for virtually seamless turnkey implementation, zero out-of-pocket costs for ACOs/practices, and minimal disruption to daily operations. Who benefits from attending this session? ACOs determined to improve management of patients with uncontrolled hypertension and diabetes, medication adherence, and achieve meaningful reduction to total cost of care.

Sponsored by Brilliant Care

Opening Plenary

Speaker: CMMI Director, Meena Seshamani, Director, Center for Medicare, CMS

Roundtable Discussion: ACOs vs. MA: Opportunities and Challenges to Achieve Savings and Innovate Care across Models
Moderator: Emily Brower, Trinity Health
Panelists: Yates Lennon, CHESS; Megan Reyna, Advocate Health; Nick Stine, CommonSpirit

Fixing a Broken System: Primary Care Incentives in ACO REACH
Chair: Valinda Rutledge, UpStream  
Speakers: Marc Berg, Bluerock Care and Penn Ave Health ACO; Eric Cragun, Castell, an Intermountain Health Company; Andrea Osborne, VillageMD

This panel is aimed towards participants of the CMS ACO REACH model as well as other total cost of care value-based payment models. The presentation will provide an overview of the different “capitated” payment options including PCC (Primary Care Capitation), APO (Advanced Payment Option), TCC (Total Care Capitation), and enhanced primary care payments under the ACO REACH Model. Panelists will describe how they are utilizing these options to transform care. It will be a lively discussion of this payment model.

Building a Successful ACO from the Ground Up
Chair: Bob Rauner, OneHealth Nebraska  
Speakers: Deepika Kewlani-Varkey, Catholic Health Physician Partners; Christina Lewis, St. Luke's University Health Network; Kathy Parsons, CentraCare

Panelists will each provide a synopsis of the key interventions they have implemented that they think has led to their success in both MSSP and commercial ACO contracts followed by Q&A with attendees.  Interventions to be discussed include setting a mission and core values to facilitate success in the ACO; criteria for recruiting clinics; new clinic/clinician onboarding steps to succeed in their ACO, and education of clinicians on practice transformation; changes in staffing and additions to the care team; approaches to care coordination and care management and use of quality and utilization data to inform and guide efforts.

Leaders in Quality Excellence Award Winners Showcase
Chair: Ashish Parikh, Summit Medical Group – NJ  
Award Winners/Speakers: Jason Fish, UT Southwestern ACO; Beth Souder, Delaware Valley ACO; Shirley Wong, University of California San Francisco ACO

Three ACOs selected by the NAACOS Quality Committee to receive the 2023 NAACOS Leader in Quality Excellence Award will be recognized for their outstanding efforts to improve the quality and safety of patient care and advance population health goals. During this session, the winners will showcase their exemplary efforts in quality improvement and disseminate best practices.

HCCs - From Genesis to Reconciliation
Chair: Henish Bhansali, Duly Health and Care  
Speaker: Logan Ferrie, Vytalize Health; Drew Guerra, Aledade; Jennifer Leazzo, Duly Health and Care; Nathan Moore, BJC ACO

This panel wants you to come away with a comprehensive understanding of HCCs and how to position yourself best to take risk and optimize your position if you are already in risk-based arrangements – MSSP, ACO REACH, or MA . To that end, with a few key slides, lots of Q/A, and a fireside chat format, panelists will talk through:

• Genesis of HCCs – why they were created, and how they are used as an APM
• Understanding risk - data, analytics, and reimbursement cycles: data files, timing of payments, sweeps, working with CMS, and benchmarking
• Capturing risk – strategy and operations around retrospective, concurrent, and prospective chart reviews; AI/NLP, and CDI use
• Managing risk – compliant documentation, clinical interpretation, and management of captured risk; process and implications of recapture YoY
• What’s next – V24 to V28 transition and implications for MA, MSSP, and REACH

Lunch Plenary    

Speaker: Christopher Koller, Millbank Memorial Fund

REACHing for Sanity in ACO Compliance
Chair: Kim Busenbark, Wilems Resource Group
Speakers: Eric Becker, Aglion Health; Kate Casaday, CareMount; Michelle Leslie, MaxHealth

Can you Crush Your Audits (CYA)? REACH ACOs will be audited this year. To keep your sanity in PY23, join a panel of compliance and operations experts as we discuss the implications of compliance requirements within the ACO REACH Model. You’ll hear about hurdles during implementation, how compliance and operations should work together, and what steps your ACO can take now to ensure you have a plan to CYA.  

MSSP Benchmarking Basics for the Present and Future
Chair: Stephen Nuckolls, Costal Carolina Quality Care  
Speakers: Mike Badome, Evolent Health; Travis Broome, Aledade; Aisha Pittman, NAACOS

Benchmarks are critical to success in the MSSP and other value-based programs.  This panel will review the present mechanics of these calculations, the scheduled changes, and the current considerations around administratively set benchmarks.  There will also be discussion around how the location or composition of your ACO’s providers may provide benchmark benefits or challenges.

Promoting High Performing Specialist Care in Your ACO
Chair: Rob Mechanic, Institute for Accountable Care  
Speaker: Jen Perloff, Institute for Accountable Care; Arshad Rahim, Mount Sinai Health System; Anthony Reed, ChristianaCare

Engaging specialists in value-based care is a challenging enterprise when their payment incentives are mostly fee-for-service. This session will explore a range of strategies for engaging specialists that include education, measuring specialist performance using episodes of care, creating processes to enhance PCP-specialist collaboration, and establishing new financial incentive models. We will explore these strategies from the perspective of a large ACO with employed specialists and a single EMR and a smaller ACO with independent specialists.

What’s RURAL Got to Do with It?  Implementing Successful Care Management & Patient Support Strategies in Rural and Low-Revenue ACOs
Chair: Jessica Martensen, Essentia Health  
Speakers: Maria Basso Lipani, Mount Sinai Health System; Rachael Lesch, CentraCare; Bob Rauner, OneHealth Nebraska

This session will discuss innovative care management and patient support strategies for addressing engagement, access to care, and social determinants of health for underserved populations.

 Friday, May 5

How Artificial Intelligence and Machine Learning Can Drive Success in ACO REACH and Other Value-Based Payment Models – A Conversation with UpStream and ClosedLoop
Speakers: David Grapey, UpStream; Andrew Eye, ClosedLoop

UpStream is an inaugural 2023 ACO REACH participant with more than 180,000 seniors supported through a whole-person care model. UpStream supports patients and providers by embedding pharmacists and other clinical staff into practices and supports physicians with proprietary technology that anticipates patient needs, supports patient care, improves quality, and helps coordinate care for seniors with chronic conditions. To improve the targeting of high-risk individuals, UpStream partnered with ClosedLoop, the Best in KLAS winner for Healthcare Artificial Intelligence: Data Science Solutions for 2 years running. Join speakers for a discussion on how UpStream is using AI and machine learning to efficiently deliver high-touch, preventive interventions that preserve patient independence and result in better outcomes for everyone.

Sponsored by ClosedLoop.ai

Sponsored Breakfast: 50,000 Feet to Landing: Analytics from a Business Leader Perspective
Speakers: Anna Basevich, Arcadia; Shannon Banks, MaineHealth ACO; Tiara Swindell, Tandigm Health

As an ACO business leader, we often view clinical operations from 50,000 feet. Every pilot knows that navigational courses are best charted with clinical data, but that's a lot of altitude to cover. In this conversation, we will discuss methods and best practices around effectively engaging with analytics teams to understand what's happening on the ground, optimize GPS, and find real impact.

Sponsored by Arcadia

Sponsored Breakfast: Leveraging Screening Technologies to Enhance Value-Based Healthcare
Speaker: Robert Bosley, Semler Scientific

FFS Medicare is going away and the transition to Value-Based Medicare is scheduled to end in 2030! The early detection of chronic diseases offers an opportunity to optimize medical management with the potential for modifying disease progression, improved long term outcomes and reduced cost. Semler Scientific’s mission is to develop, manufacture and market innovative products and services that assist our customers in the early detection of chronic diseases. QuantaFlo® is an easy to use, accurate, non-invasive point of care device for the early detection of Peripheral Vascular Disease (PAD) and Heart Dysfunction (HD). The presentation will focus on how these two diseases represent a significant cost burden to healthcare providers and the importance of early detection in managing long-term cost.

Plenary
Speaker: Liz Fowler, CMS Deputy Administrator

eCQMs and CMS's Vision for Digital Measurement 
Chair: Jennifer Gasperini, NAACOS
Speakers: Remy DeCausemaker, Tim Jackson and Molly MacHarris, CMS; Megan Reyna, Advocate Aurora Health; Jessica Walradt, Northwestern Medicine

This session will feature presenters from The Centers for Medicare and Medicaid Services (CMS) who will share details on the CMS digital quality strategy. This will also include a discussion of recent guidance provided to ACOs on electronic clinical quality measures (eCQMs) and Merit-Based Incentive Payment System (MIPS) CQM implementation issues. Additionally, the US Digital Service will discuss upcoming projects CMS is undertaking to support ACOs’ transition to eCQMs. Finally, ACOs will share their perspectives and insights as they work to implement eCQM reporting.

NAACOS Advocacy Update and Specialty Engagement Discussion with CMS
Chair: Aisha Pittman, NAACOS
Speakers: Robert Daley, Alyssa Neumann and David Pittman, NAACOS; Sarah Fogler, Rachel Roiland and Anna Goldman, CMS

NAACOS staff will provide an update on NAACOS’s efforts to ensure ACOs remain successful in the program and drive innovation for ACOs. This session will include provide updates on key policies for MSSP and REACH ACOs, fee-for-service policies that impact ACOs, NAACOS congressional and regulatory advocacy, and efforts to advance value across payers. Additionally, CMS will provide and update on the CMS specialty engagement strategy.  

Uncovering the Strengths of a Federally Qualified Health Center Partner in a Value-Based Market
Chair: Margarita Ollet, Health Choice Care, LLC
Speakers: Meredith Marsh, Health Choice Care; Alejandro Romillo, Health Choice Care; Merrill Thomas, Providence Community Health Center  

The aim of this session is for attendees to gain an understanding of the governance and operating principles of a Federally Qualified Health Center (FQHCs).  Join this session to learn more about the role FQHC’s play nationally and locally and how they are an integral community provider in today’s value-based market.

Pharmacy Strategies that Improve Patient Care
Chair: Tiffany Jenkins, Trinity Health  
Speakers: Sheireen Huang, CHESS Health Solutions; Sara McElroy, HarmonyCares

Pharmacy management within ACOs is constantly evolving and advancing. This session will highlight examples of clinical and cost containment strategies employed by ACOs to see success in patient care as well as clinical and financial outcomes. Presenters will share real-world examples of how they have designed, implemented  and supported pharmacy care models and highlight developed best practices and practical considerations for pharmacy strategies that will improve patient care within an ACO. 

Addressing Health Disparities to Drive Equitable Outcomes
Chair: Laura Larssen, MaineHealth ACO  
Speakers: Naomi Senkeeto, BCBSSC; Karen Wilding, Nemours

Healthcare outcomes have been historically unequal and vary depending upon a population’s race/ethnicity, gender, socioeconomic status, sexual orientation, geography, or language. This session will explore strategies for identifying existing health disparities, building reporting capabilities to measure outcomes, engaging providers around health equity work, and implementing systems for improvement. We will share approaches for addressing health equity from the perspective of a pediatrics institution, a health plan, and a large, statewide ACO.

Exploring Innovations, Opportunities and Challenges in Rural Health and the Impact on Value-Based Care
Chair: Debbie Welle-Powell
Speakers: Shannon Banks, MaineHealth ACO, Jennifer Lundblad, Stratis Health and Rural Health Value; Michael VanScoy, Arkos Health  

This session will explore innovations, opportunities, and challenges in rural health and their impact on value-based care. Attendees will learn about how digital care is supporting and enhancing patient care and the patient experience in rural settings. Presenters will review best practices and key elements in creating a virtual digital strategy. Attendees will also gain insights from leading rural health systems who share their goals for value-based care, payer partnerships, and enhanced patient outcomes, and learn about prioritizing and integrating health equity in a rural setting.

Evolution & Revolution of Primary Care: Multiple Paths to Success 
Chair: Arshad Rahim, Mount Sinai Health System
Speakers: Amanda Furr, VillageMD; Kevin McNeill, Lehigh Balley Health Network ACO; Ashok Roy, Signify Health

Today, there are multiple innovative models of primary care.  This session seeks to provide a quick overview of the leading primary care models.  The majority of time will focus on panelists speaking to staffing models and keys to success, how these primary care practices and centers achieve financial sustainability, and integration across various modes of care delivery.  These modes include virtual, in-person, remote patient monitoring and retail connections.

Demystifying Benchmarking Under ACO REACH
Chair: David Pittman, NAACOS  
Speakers: Samuel Johnmeyer, PSW and MultiCare Connected Care; Yubin Park, Apollo Medical Holdings; Arjun Prakash, CMMI; Frank Richter, ilumed

Few policies are as important to ACOs as financial benchmarking. However, few policies are as complicated as benchmarks, which has been particularly volatile under ACO REACH. This panel will review ACO REACH’s benchmarking policies and discuss timely topics like its retrospective trend adjustment and the health equity benchmark adjustment. Attendees should come away with a better understanding of the model’s financial methodology and what they can expect – as best we can predict – in the months ahead.

CMS Town Hall  
Moderator: Aisha Pittman, NAACOS
Speakers: John Pilotte and Pauline Lapin, CMS

This session includes a town hall format and is an important way for ACOs and CMS to have an open dialogue about important Administration priorities, the shift to value-based care, and the Medicare ACO program, including discussion on evolving policies and how ACOs fit into CMS’s overall goal of improving Medicare payment and healthcare delivery. This is an excellent opportunity for ACO executives to pose questions and receive answers directly from CMS leaders and to hear the newest developments straight from the agency.