Lynn Barr, Author at National Rural ACO

CY2017 Physician Fee Schedule Proposed Rule Continues Trend Towards Value-Based Payments

CMS’s 2017 Physician Fee Schedule (PFS) proposed rule offers a lot for organizations interested in transformation to celebrate. In addition to making a number of tweaks to the Shared Savings Program that demonstrate CMS leadership are listening to provider feedback, the proposed rule removes barriers for rural health care organizations to offer more preventative and consultative services.

Most importantly, CMS proposes to remove the requirement for direct supervision in rural health clinics and federally qualified health centers when providing comprehensive care management (CCM) services. When CMS first finalized CCM as a billable service, the agency determined that for rural clinics and federally qualified health centers the primary practitioner must directly supervise all aspects of the care. In the proposed rule CMS would allow such facilities to use general supervision for services incident to CCM, just as currently allowed in a standard physician office.

CMS also simplified the conditions for practitioners operating in all settings to provide CCM services, removing cumbersome requirements for a comprehensive pre-visit as well as written agreement to receive services and share health information. They also propose important new payments for care coordination and behavioral health integration. Caravan Health will assist you in implementing these new codes once approved.

Additionally, in a significant sign that CMS is thinking about our rural members, two new telehealth codes are proposed that will allow clinicians to offer advance care planning remotely.

CMS also proposes a new program focused squarely on prevention in high risk populations. The Medicare Diabetes Prevention Program would begin January 1, 2018 and offer an opportunity for providers to partner with local community organizations or even host prevention programs themselves. CMS is seeking comments on all aspects of the new program, and we expect to see at least one more round of additional rule-making on this before the program rolls out.

Finally, CMS is proposing a few new quality measures and sun-setting others. They also propose changes to the audit process and are considering beneficiary self-assignment.

Click here to read Caravan Health’s full analysis of the proposed rule.

We will have a webinar to review the proposed rule on Tuesday, Aug. 23 at 9am PT/11am CT/12pm ET. To join, log in to www.readytalk.com, participant code 5004777. If you are unable to access the web-audio function, dial 303.248.0285.

Comments on the proposed rule will be accepted by CMS until 5pm EST September 6, 2016. A final rule is expected no later than November 1, 2016.

LeeAnn Hastings

Director of Policy & Compliance

Caravan Health

Lynn Barr August 15, 2016 Accountable Care Organization, CMS, Healthcare Policy, Payment Reform, Value-Based Payment Read more >

CPC+ Practice Application Open in 14 Regions

This information is provided by the Centers for Medicare and Medicaid Services

On August 1, CMS opened the application for practices to apply for Comprehensive Primary Care Plus (CPC+), the largest-ever initiative to improve primary care in America. CPC+ rewards value and quality through an innovative payment structure to support comprehensive primary care.

In CPC+, CMS has provisionally selected 57 payer partners, including commercial insurers, state Medicaid agencies, Medicaid managed care organizations, and Medicare Advantage plans in 14 regions across the nation.

Click this link to view a pdf map showing the 14 CPC+ regions and provisionally selected payers: https://innovation.cms.gov/Files/x/cpcplus-payerregionlist.pdf

Want to learn more about CPC+?

Get your questions answered in the Practice FAQs.
Register for one of the 20 upcoming CPC+ Practice Open Door Forums in August and September.
Watch the CPC+ Video Series to get an overview of CPC+ payment innovations and care delivery transformation.
Submit a CPC+ application via the online portal today through 11:59pm ET on Thursday, September 15.
Download the CPC+ toolkit: CPC+ In Brief, CPC+ Care Delivery Transformation Brief, and CPC+ Payment Innovations Brief and Case Studies.

At CMS, we believe CPC+ is the future of primary care in America. We are pleased to partner with aligned public and private payers across the country to support up to 5,000 practices delivering the care that best meets the needs of their patients and improves health outcomes.

Sincerely,

The CPC+ Team

Lynn Barr August 8, 2016 Accountable Care Organization, CMS Read more >

Caravan Health / National Rural Accountable Care Consortium Sign Up More Than 10% of all Million Hearts Grantees

Austin, Texas – July 26, 2016 – Caravan Health and National Rural Accountable Care Consortium announced today that they were successful in signing up more than 10% of all Million Hearts practices, including the majority of rural practices accepted into the program. Million Hearts is a national initiative with an ambitious goal to prevent 1 million heart attacks and strokes by 2017. According to Lynn Barr, CEO of Caravan Health, “This is another major milestone for our providers. Million Hearts is a terrific program that will reduce the number of heart attacks in at-risk patients, while paying providers well to implement the program.”

At first Caravan Health was not able to recruit providers for the program because patients that were in Million Hearts were not eligible for Chronic Care Management fees, a net loss of $400 per patient per year. After notifying the Center for Medicare and Medicaid Innovation (CMMI) of the dilemma, CMMI modified the rule to avoid exclusion of Care Management Payment, but only three days before the application deadline.

Caravan Health’s customer service team dropped what they were doing and called and emailed hundreds of practices right up to the deadline, providing them with a sample application and encouraging them to apply. “Our providers will receive an extra $16 million for participation, and thousands of heart attacks will be avoided. Everybody wins.” says Tristan Del Canto, who manages the customer service team.

The Consortium and Caravan Health have a highly successful track record in helping providers apply for value-based payments. “More than 90% of our AIM ACO applications were successful and make up more than 50% of all AIM ACO’s in the nation,” says Monica Bourgeau, Executive Director of the Consortium. “In addition, the Consortium was awarded a $31 million Transformation of Clinical Practice Initiative grant to assist providers to move into value-based payments, and we have already enabled hundreds of independent, rural and safety net primary care practices join value-based payment models.”

The number of practices that have signed up for the National Rural Accountable Care Consortium’s Practice Transformation Network is more than four times what was anticipated in the grant application. Almost half of those practices are small practices in urban settings who benefit from setting up the same simple, sustainable programs of care coordination and wellness and prevention. Practices preparing for MACRA and other advanced payment models are provided software, training and 24/7 advice nurse hotlines at no cost under the Consortium’s program. The Consortium is a 501c3 organization which contracts its transformation services to Caravan Health.

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

Lynn Barr July 27, 2016 Accountable Care Organization, News Read more >

Read Our July 2016 Care Coordination Newsletter

In our July Care Coordinator Newsletter, we share important program news, informative tips and first-hand accounts from the field of care coordinator success stories and the many lives being changed for the better.

Click here to read the newsletter.

Lynn Barr July 25, 2016 Accountable Care Organization Read more >

Qualify for Comprehensive Primary Care Plus Program by September 15 Deadline

Comprehensive Primary Care Plus (CPC+) will pay well-deserving primary care providers an additional $100,000 to $250,000 per year, in addition to fee-for-service, for care that has previously been largely uncompensated.

Today, primary care physicians spend many hours outside the exam room, documenting patients’ history and following up on referrals, but do not get paid for activities that are not face to face. CPC+ allows doctors to spend more time during the day with patients and less time after hours on paperwork.

Track 1 and Track 2 participants are paid $180,000 to $320,000 per 1,000 patients per year for Care Management Fees, respectively, and are also eligible for $30,000 to $48,000 per year in incentive bonuses. In both tracks of the program, practices must have a care coordinator, promote wellness, use claims data, have 24/7 access, align patients with providers and report on quality.

In addition to the aforementioned $320,000, Track 2 primary care providers can get as much as 71.5% of the reimbursement previously confined to face-to-face visits, using patient-pleasing methods such as phone, email, or text advice. All procedures and routine office visits are still fully billable under the physician fee schedule, sometimes for higher rates. In either track, beginning in 2019, the practice will also receive a MACRA payment of 5% of Part B billing for five years and will be exempt from the Quality Payment Program (if the practice has fewer than 50 physicians). Participation regions and states will be selected by August 1st.

Applications are due September 15. This is a multi-payer program.

The 5,000 practices that can participate in the model may be determining the fate of primary care payments for decades to come. The Comprehensive Primary Care Initiative was the most generous program to date under CMMI, and well received by providers, but only broke even in cost savings. It’s sequel, Comprehensive Primary Care Plus promises to go even farther in both the incentives and the requirements of the program. If successful, the Secretary has the power to make the program permanent, and CPC+ pioneers can define a bright future for primary care payments.

To be eligible, practices must already have a care coordinator, promote wellness, have 24/7 access, align patients with providers and use data for care. Most small practices will not qualify without focused effort to implement the qualifying programs in a short period of time. To get assistance, please go to CaravanHealth.com.

Lynn Barr July 23, 2016 Accountable Care Organization, CMS, Healthcare Grants and Funding Read more >

CPSI and Caravan Health Announce Partnership to Help Rural, Community Providers Transition to Value-Based Care and Reimbursement

MOBILE, Ala.–Jul. 20, 2016– Healthcare technology leader CPSI (NASDAQ: CPSI) today announced a partnership dedicated to helping rural and community providers transition through new healthcare delivery and reimbursement changes that are driven by healthcare outcomes, the quality of healthcare provided and the goal of keeping people healthy. This new partnership will help rural providers who currently use the Thrive EHR or the recently acquired Healthland Centriq EHR access customized training, education and skill-building tools to incorporate more direct and personal primary care programs while increasing reimbursement and revenue.

Caravan Health, the services arm of the National Rural Accountable Care Consortium, supports rural providers and health systems to build clinical practices and infrastructure for value-based reimbursement programs.

Boyd Douglas, president and chief executive officer of CPSI, said, ³To most effectively adapt to and manage changes in value-based reimbursement, rural and community hospitals and healthcare providers need focused, coordinated assistance from their healthcare IT partner, combined with a customized training and education component. We believe this agreement with Caravan Health delivers that assistance.²

Commenting on the agreement, Lynn Barr, MPH, chief executive officer of Caravan Health, said, ³We welcome this partnership with CPSI, which, through its Thrive and Centriq product sets, is at the forefront of helping rural providers and health systems improve the measurement of quality scores and outcomes, as required under the changing reimbursement regulations.²

Douglas added, ³Our strategy and product offerings are designed specifically for rural and community care settings and their unique needs, CPSI recognizes that smaller health systems struggle with deciding how and where to begin the process of aligning the care they provide with the new value-based reimbursement models. We look forward to partnering with knowledgeable Caravan Health trainers to help our clients deliver the quality care they know works for their family, friends and neighbors – and be fairly compensated for that care.

³We are investing in our customers¹ long-term success through this partnership, which reinforces CPSI¹s commitment to the community healthcare marketplace. We have 35 years of experience helping rural and community hospitals operate more efficiently, and with this year¹s acquisition of Healthland, post-acute EHR American HealthTech, RCM Software Automation software company Rycan, and the development of new solutions focused on this market, we believe we are well positioned to further assist these providers in improving the overall health of their communities,² Douglas said.

Lynn Barr July 21, 2016 Accountable Care Organization Read more >

Focusing on Primary Care for Better Health

Have you seen the proposed changes for the 2017 Physician Fee Schedule? If you own, operate, or practice in a primary care clinic, you need to take 5 minutes this weekend and read how Andy Slavitt, CMS Acting Administrator, is now focusing on primary care for better health.

Four short years ago, working alongside the visionary cohort of the National Rural ACO, we began a patient-focused movement, aligning the expectations of healthcare payors with the best possible health outcomes for patients and communities. Today, our models for care coordination, evidence based medicine, clinically integrated networks, delivery system reform, quality reporting and patient engagement are being co-opted by the entire healthcare industry, and we could not be happier.

Under the new proposed rule, our common sense approach to improving care outcomes will also increase practice revenue, by as much as a third, with services provided by your care team.

If you are in primary care and you have not already begun transformation towards the new value-based models for care delivery and compensation, you must act now to take advantage of the generous and comprehensive opportunities healthcare payors are offering in 2017. Truly, this is the opportunity of a lifetime. But don’t wait. The time to act is now and the opportunity to join the most important program for primary care, CPC+, will be gone in just a few short weeks.

Caravan Health is here to help. It is no coincidence that the services and strategies we provide align so closely with what CMS is now adapting into policy. We have grant-funded programs, running now, to get your practice off the ground and into the new payment models. You’ll see that our solutions are operational, not theoretical. We work side-by-side with your staff, providing the training and development they yearn for, at no additional cost to you. We will focus on what is most important for you and your patients, easing the transition to value based care.

Our history, our success, is grounded in a fundamental belief in the role primary care plays in better health outcomes. It is our approach to take any practice, any hospital, from any community and to integrate simple, operational solutions that produce the real and measurable results payors now demand.

In just a few short weeks, you and your staff can be on your way, perfectly positioned for a brighter and healthier future, as our nation and our healthcare system turns a renewed focus to primary care for better health.

Lynn Barr July 8, 2016 Accountable Care Organization Read more >

Read Our June 2016 Care Coordination Newsletter

We’re excited to share our June 2016 Care Coordinator Newsletter. In this edition we delve into a resourceful CMS tool which helps manage beneficiary eligibility, summer heat tips to remember when caring for patients and three wonderful success stories straight from the field. Enjoy reading!

Click here to read.

Lynn Barr July 1, 2016 Accountable Care Organization, CMS Read more >

Shannon Calhoun Appointed to Texas Health Services Authority Board of Directors

Austin, Texas – June 30, 2016 – Texas Governor Greg Abbott has appointed Shannon Calhoun, Regional Vice President of the National Rural Accountable Care Consortium, to the Texas Health Services Authority Board of Directors.

The THSA serves the public healthcare system of Texas by coordinating the implementation of technologies that work to enhance doctor and patient experience. Established in 2007, THSA utilizes a health information exchange to allow for secure release of medical records on a need-to-know basis. The goal of this effort is to increase coordination and quality of care while improving efficiency and consumer control.

Calhoun stated, “I am honored to continue to serve Texas as a Director of the Texas Health Services Authority. My hope is that with the knowledge of rewards and challenges our Texas clients experience in sharing data, I will be able to promote an environment for providers to succeed in today’s healthcare transformation.”

An active member of her community, Calhoun was a member of the Goliad County Chamber of Commerce Finance Committee, Goliad Community Network, Goliad Rotary Club and the Pecan Valley AHEC board. Calhoun received her Bachelor of Science in agronomy from Texas A&M University and was named as one of Texas A&M University’s “Aggie 100” in 2011, 2013 and 2014.

CONTACT:

Bryan Hagar

Communications Director

Caravan Health

916 542 4583

bhagar@caravanhealth.com

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Lynn Barr June 30, 2016 Accountable Care Organization, News Read more >

National Rural Accountable Care Consortium Offers Free Participation in Medicare Shared Savings Program

FOR IMMEDIATE RELEASE

Beaverton, Oregon – June 28, 2016 – Today the National Rural Accountable Care Consortium (NRACC) announced that Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs), rural hospitals with less than 100 beds and independent practices may be eligible for free participation in the Medicare Shared Savings Program (MSSP).

NRACC anticipates many primary care providers will be moving into the new Comprehensive Primary Care Plus (CPC+) program this fall. This movement will allow other providers, not participating in the CPC+ program, to move into ACO Investment Model (AIM)-funded ACOs, where practices can receive all of the benefits of the Medicare Shared Savings Program at no cost.

Interested applicants must submit a non-binding application no later than July 15, 2016. If approved by the ACO Boards of Directors, successful applicants will be notified in October and have five business days to either confirm or withdraw their application.

“Accountable Care Organizations are a great way to get the data we need to help our patients,” says Dr. Mark Hamed, Medical Director of the Greater Michigan Rural ACO, an NRACC member. “The changes we have made in our practice workflows improve care for our patients and make it easier to practice medicine the way we have always wanted.”

McKenzie Health System CEO Steve Barnett agrees, “Patient-centered care under the ACO model has been great for our community and great for the bottom line of our rural health system. Patients leave the community for care less frequently, increase their preventive care compliance and stay healthier as a result.”

CPC+ is a new primary care payment initiative from the Centers for Medicare and Medicaid Services (CMS). According to NRACC Executive Director Monica Bourgeau, “CPC+ and the MSSP are two ways providers can participate in Advanced Payment Models. The MSSP greatly improves their results under MACRA. CPC+ is a Qualified Advanced Payment Model that exempts providers from MACRA and automatically earns a 5% Part B bonus. Either way providers and patients are better off.”

CONTACT:
Monica Bourgeau, MS
Executive Director
National Rural Accountable Care Consortium
www.NationalRuralACO.com
ptn@nationalruralaco.com
916.500.4777 (o)

Lynn Barr June 28, 2016 Healthcare Grants and Funding, Medicare Shared Savings Plan, News Read more >

Author Archive: Lynn Barr