Author Archive: Lynn Barr

New Administration Sends Positive Smoke Signals About Value-Based Payments

Last week, the CMS announced a delay in publishing the final rules regarding the new mandatory cardiac and joint bundled payment programs. Significantly, the CMS did not dethe start dates of those programs, put them on hold, or cancel them all together. The new bundled payment programs will begin as scheduled, but the new administration will have a chance to make minor tweaks prior to the July 1 start date.

In spite of Secretary Price’s previous objections to mandatory CMMI programs, the green light from CMS foreshadows a continued commitment to value-based payments. A strong case can be made that the delivery system reforms instituted under the Affordable Care Act are a unique example of successful government intervention. There is compelling evidence to show that these programs have improved the quality of care for millions of people, saved hundreds of thousands of lives, and reduced spending by billions of dollars.

The pressure to reform will continue. Every provider needs to engage in value-based payment models today and begin the learning process. Currently, 30% of providers are engaged in value-based models. Provider engagement is expected to increase to 50% by 2018.  Now is the time to move forward or risk falling behind half the providers in America.

Several companies offer low-cost, supported participation in the Medicare Shared Savings Program for the third of physician groups who do not have 5,000 Medicare lives on their own. These companies include Collaborative Health Systems, Aledade, and Caravan Health.

Applications for 2018 are due to CMS on July 31st, with CMS letters of intent due by May 1st. Please reach out to us at info@caravanhealth.com if you would like to learn more.

 

 

February 20, 2017 CMS, Value-Based Payment Read more >

Accountable Care Symposium to Focus on Emergency Department and Inpatient Transitions of Care

Austin, Texas – November 29, 2016 – The Caravan Health two-day Accountable Care Symposium on January 11 and 12, 2017 at The Pointe Hilton Tapatio Cliffs in Phoenix, Arizona, will provide hands-on training for ACO’s, CPC+ participants and forward-thinking primary care practices that want to learn simple techniques that improve care, lower cost and help practices earn significant bonuses under MACRA.

The Caravan Health Accountable Care Symposium will teach proven methods for implementing Comprehensive Primary Care (CPC+) Programs, Accountable Care Organizations (ACO’s) and new, billable primary care services. In addition to focusing on a variety of key topics in population health, the Symposium will teach emergency department and inpatient follow up procedures. Hands-on workshops will provide key materials and training to help attendees to strengthen their skills and gain confidence carrying out these processes.

  • Receive scripts, tools and training to approach high volume hospitals and emergency departments to develop notification processes upon discharge.
  • Receive training on protocols for scheduling post-discharge follow-up with your nurse.
  • Learn how to bill for Transitional Care Management Services.

“Our patients are highly vulnerable during these transitions from the hospital and emergency department settings.” stated Lynn Barr, CEO of Caravan Health. “This program will help our practices help our patients when they need it the most.”

The first day of the symposium will be dedicated to policy: explaining the interaction between MACRA and advanced payment models and showcasing real world experiences from pioneers of accountable care and practice transformation. The second day will feature hands-on workshops that will provide instruction on how to simply and affordably implement chronic care management and behavioral health interventions, in addition to wellness, risk adjustment and stratification programs. A special workshop will be dedicated to MACRA’s new Advancing Care Information category, providing practical tips on how to implement the workflows that will achieve the highest scores.

Participants that are currently enrolled in the Caravan Health ACO or CPC+ programs or are participating in any Practice Transformation Network may attend the Symposium at no cost if they register by December 15, 2016. A complete agenda and registration are available through the Caravan Health website www.CaravanHealth.com.

About Caravan Health:
Caravan Health helps providers implement population health programs with affordable, end-to-end solutions that achieve outstanding results.

 

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CONTACT:
Bryan Hagar
Communications Director
Caravan Health
916 542 4583
bhagar@caravanhealth.com

November 30, 2016 Accountable Care Organization, News Read more >

Care Coordination to be Featured at the Caravan Health Accountable Care Symposium

Join hundreds of accountable care pioneers to learn how rural hospitals, clinics, small practices and independent providers can achieve better outcomes and higher earnings.

Austin, Texas – November 21, 2016 – The Caravan Health two-day Accountable Care Symposium, to be held January 11 and 12, 2017 at The Pointe Hilton Tapatio Cliffs in Phoenix, Arizona, will provide hands-on training for ACO’s, CPC+ participants and forward thinking primary care practices that want to learn simple techniques that improve care, lower cost and help practices earn significant bonuses under MACRA.

In addition to covering a number of other prominent topics in population health, the Symposium will help participants learn tried and true methods for implementing CPC+, Accountable Care Organizations, and new, billable primary care services. Hands-on workshops will help practices set up the following programs

  • Chronic Care Management
  • Transitional Care Management
  • Risk stratification
  • Empanelment

Participants can meet and network with experienced care coordinators who have already implemented these programs successfully in hospitals, rural health clinics, Federally Qualified Health Centers and primary care practices.

“Care coordinators are the heart and soul of population health. These workshops will teach practices how to set up successful care coordination programs that improve outcomes and are financially sustainable.” stated Lynn Barr, CEO of Caravan Health.

The first day of the symposium will be dedicated to policy: explaining the interaction between MACRA and advanced payment models and showcasing real world experiences from pioneers of accountable care and practice transformation. The second day will feature hands-on workshops that will provide instruction on how to simply and affordably implement chronic care management and behavioral health interventions, in addition to wellness, risk adjustment and stratification programs. A special workshop will be dedicated to MACRA’s new Advancing Care Information category, providing practical tips on how to implement the workflows that will achieve the highest scores.

Participants that are currently enrolled in the Caravan Health ACO or CPC+ programs or are participating in a Practice Transformation Network may attend the Symposium at no cost if they register by December 15, 2016. A complete agenda and registration are available through the Caravan Health website www.CaravanHealth.com.

About Caravan Health:
Caravan Health helps providers implement population health programs with affordable, end-to-end solutions that achieve outstanding results.

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CONTACT:
Bryan Hagar
Communications Director
Caravan Health
916 542 4583
bhagar@caravanhealth.com

November 22, 2016 Accountable Care Organization, News Read more >

CMMI Notifies Comprehensive Primary Care Practices of Acceptance

Caravan Health to hold webinar to review on-boarding packet, Monday, 2:00pm EDT

Austin, Texas – November 17, 2016 – Thousands of primary care providers have been notified of acceptance into the Comprehensive Primary Care Plus (CPC+) program. Successful applicants are receiving on-boarding documents and instructions for submission by December 1st, 2016. Caravan Health, who is supporting many of the CPC+ practices, will be providing a webinar to review the on-boarding packet to help practices submit the paperwork quickly and easily. The webinar is open to the public and is free of charge.

The registration link for the webinar is:

https://caravanhealth.webex.com/caravanhealth/onstage/g.php?MTID=e68fd09b29bdc0a618816a6689daadca2

  • Event Number: 662 161 178
  • Event Password: CPC1121
  • Date: Monday, November 21, 2016
  • Time: 11:00am PT | 1:00pm CT | 2:00pm ET

In addition, the Innovation Center is releasing guidelines and requirements for behavioral health integration for practices that are in Track Two of the CPC+ program, or previously participated in the Comprehensive Primary Care Initiative (CPCI). These guidelines will be addressed in the webinar with a discussion of the related codes for behavioral health integration found in the 2017 Physician Fee Schedule.

“We have been inundated with calls and emails from practices that are thrilled to be part of this important new payment model for primary care,” commented Lynn Barr, CEO of Caravan Health. “Many will attend the Caravan Health Accountable Care Symposium in Phoenix, AZ on January 11th and 12th, to participate in hands-on, peer-to-peer workshops, that will help practices quickly and successfully implement these new models.” For more information about the Symposium, go to http://www.caravanhealth.com.

About Caravan Health:

Caravan Health helps providers implement population health programs with affordable, end-to-end solutions that achieve outstanding results.

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CONTACT:
Bryan Hagar
Communications Director
Caravan Health
916 542 4582
bhagar@caravanhealth.com

 

November 17, 2016 Accountable Care Organization Read more >

Final Rule MSSP Program

By LeeAnn Hastings, Director of Policy and Compliance

The Physician Fee Schedule (PFS) final rule was released by CMS in early November. The rule broadly establishes payment rates for physicians and makes other changes to the Medicare Part B program for calendar year 2017 (CY2017). Among the changes finalized for 2017 include important modifications to the Medicare Shared Savings Program for Accountable Care Organizations (ACOs) and their participant providers.

In the final rule, CMS created some important flexibility for providers that participate in an ACO and looking ahead, an opportunity for providers to increase the certainty of their patient population.

Typically, an ACO is responsible for reporting required quality data on behalf of its providers. Providers that do not report this data are currently penalized, or in the case of ACO participants, if the ACO does not report on their behalf. With the new rule, CMS will now allow providers to independently report their quality data, which in the event their ACO fails in its obligation, will prevent the provider from facing a penalty. The rule allows physicians to back-report for both the 2015 and 2016 performance years; and will carry forward the policy as we shift to payment under the Quality Payment Program (QPP) in the 2017 performance year.

CMS also finalized its proposal to explore a voluntary attestation process for 2018. Under this system, patients would be able to declare their “home” doctor, and the ACO would know in advance that such patients were assigned to the ACO. More details on this process will be released through sub-regulatory guidance and outreach.

Finally, CMS used the final rule to make adjustments to the quality measure set for 2017. More information on technical changes to quality measures and quality validation is contained in the PFS Shared Savings Program brief HERE.

In future blog posts we will discuss important coding changes in the final rule as well as the expanded Diabetes Prevention Program.

November 12, 2016 Accountable Care Organization Read more >

Introducing the New Quality Payment Program from CMS

If your practice bills Medicare more than $30,000 a year and provides care for more than 100 Medicare patients, you will now be in the Quality Payment Program established under MACRA, The Medicare Access and CHIP Reauthorization Act of 2015.

The Quality Payment Program replaces the previous Sustainable Growth Rate formula and is broken down into a two-track framework: Advanced Alternative Payment Models (APMs) or the Merit-based Incentive Payment System (MIPS). Most providers will participate through the MIPS track which will award an incentive or a payment penalty based upon performance on quality, cost, use of electronic health record technology and improvement activities. Participation in the Advanced APM path will require clinicians to take on more financial and technological risk but will yield a 5% lump-sum incentive payment.

Throughout the performance year, practices will need to record the quality of care they provide and the type of technology used. Medicare will utilize this information to give feedback about performance and determine incentive payments and adjustments.

Practices can pick their pace for the Quality Payment Program starting on January 1, 2017 with first payment reimbursements going into effect on January 1, 2019.

  • If MIPS eligible providers don’t participate at all, they can expect a 4% negative payment adjustment
  • If MIPS eligible providers submit one quality measure or one improvement activity for any point in 2017, there would be no adjustments.
  • If MIPS eligible providers submit for a partial year (a minimum of 90 days of 2017 data) they will receive either a neutral or small positive adjustment
  • If MIPS eligible providers submit for Full Year: Submit all 2017 data to Medicare they will receive a moderate positive payment adjustment

Rural Health Clinics and Federally Qualified Health Centers are exempt from reporting under MACRA. However, we encourage voluntary reporting to help those providers stay current with reporting requirements and to help prepare for advanced payment models.

The Consortium’s Practice Transformation Network prepares providers for participation in MACRA as well as in advanced payment models. This program is funded by the Transforming Clinical Practices Initiative from the Centers of Medicare and Medicaid Services (CMS).

Ready to learn more? Please visit https://qpp.cms.gov/.

November 4, 2016 CMS, News Read more >

No Time to Read the 2200 page MACRA Final Rule? Read the AAFP’s Executive Summary Instead.

The American Academy of Family Physicians (AAFP) has created a concise and informative executive summary of the final rule addressing implementation of the Medicare Access and CHIP Reauthorization Act (MACRA). AAFP experts have read the rule and pulled out the sections most relevant to family medicine and primary care practices.

Click here to read AAFPs executive summary of the MACRA final rule.

November 2, 2016 CMS, Healthcare Policy Read more >

Payment Model a Success for Providers, Patients and Medicare

The Advanced Payment Model demonstration project is complete. The Model was designed to test whether pre-paying shared savings would result in higher participation in the model from independent physicians and rural providers. It also tests whether such participation will lower costs and/or improve the quality of care for Medicare Beneficiaries. The ACO Investment Model (AIM) follows the same principles as Advanced Payment but also allows providers employed by Critical Access Hospitals to participate in the program.

LOWER COST:

The average Advanced Payment ACO generated $2 million per performance year, almost twice as much savings per year as the average MSSP ACO. Advanced Payment model ACO’s also saved almost five times as much per beneficiary at $241.40 per year, vs. $58.64 per beneficiary per year for all MSSP ACO’s. The program saved the trust fund $21.5 million over three years.

BETTER CARE:

For the 31 ACO’s that remained in the Advanced Payment program for three years, the average quality score increased from 90.2% to 92.9% by the third year.

MORE PARTICIPATION:

Thirty-six of the one hundred new MSSP ACO’s in 2016 are ACO Investment Model (AIM) ACO’s, an updated version of the Advanced Payment model, and more than two-thirds of them are solely rural. Most AIM participants say they would not participate in the MSSP without AIM support. The 2016 AIM program increased rural participation in ACO’s five-fold.

POLICY IMPLICATIONS:

ACO participation appears to have more impact in small and rural practices with limited experience in managing care when compared to all MSSP ACO’s. Small and rural ACO participants are likely to avoid penalties under MACRA’s quality payment program. Providing support for these practices at no net cost to the government is in the public interest.

In conclusion, the Advanced Payment model is successful in helping small practices and rural providers participate in the MSSP while improving quality and lowering per capita cost, and provides a net savings to the Medicare Trust fund. The Secretary should exercise her authority under the ACA to make the program permanently available to small and rural practices.

ALL MSSP ALL Advanced Pay
Per ACO Per Year $1,009,871 $1,975,039
Per Beneficiary Year $58.64 $241.40
Average Savings 0.58% 2.28%
Total Beneficiary Years 16,275,327 850,880
Total Savings $954,328,267 $205,404,040
Estimated Total Advanced Pay $80,684,908
Estimated Advanced Pay Repayment $38,369,312
Shared Savings Payments $1,298,712,390 $141,596,556
Net Savings (Loss) -$344,384,123 $21,491,888

 Source: https://data.cms.gov

September 13, 2016 Accountable Care Organization, Care Coordination, Value-Based Payment Read more >

Comprehensive Primary Care Plus (CPC+) – Which Track is Right for You?

Sue Dietz, MPH, presents a one-hour webinar on how primary care providers can qualify for the Comprehensive Primary Care Plus (CPC+) initiative, an innovative multi-payer program offered by the Centers for Medicare & Medicaid Services (CMS) that generously compensates providers for delivering comprehensive care.

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Through Sept. 15, eligible providers may apply for CPC+ Track 1 or Track 2, potentially earning $100,000 to $250,000 per year, in addition to fee-for-service. In this webinar, Ms. Barr differentiates between the two models and helps practices determine which track is best by providing an easy roadmap to meet eligibility requirements and a financial calculator to assess incentive payments.

CMS recently announced 14 geographical regions eligible for the five-year program including the states of Arkansas, Colorado, Hawaii, Michigan, Montana, New Jersey, Ohio, Oklahoma, Oregon, Rhode Island, and Tennessee. Additional regions are the Greater Kansas City Region of Kansas and Missouri; the North Hudson-Capital Region of New York; Northern Kentucky and the Greater Philadelphia Region in Pennsylvania.

For more information about how your practice can qualify for CPC+ in time to apply and at no cost, please go to www.caravanhealth.com.

August 22, 2016 CMS, News Read more >