Author Archive: Lynn Barr

Comprehensive Primary Care Plus Enrollment: A Window of Opportunity

A comprehensive overview of CPC+, a financially rewarding initiative from the Centers for Medicare and Medicaid Services (CMS), designed to transform your practice towards the community health and the value-based payment systems of the future.

Learn how Caravan Health can guide your practice to full qualification for CPC+ (Track 2) through the CPC+ Boot Camp, including line-by-line application assistance and hard to obtain IT Vendor Letter of Support, all at no cost to you.

Read Our April 2016 Care Coordination Newsletter

We’re kicking off spring with our revamped Care Coordination Newsletter. In the April issue, we delve into a new CMS rule proposal and how it could affect ACOs. You’ll also hear from health care executives about the concern of losing revenue when joining an ACO, and read up on heart-warming care coordination success stories straight from the field. We hope you enjoy reading.

Click here to read our April 2016 Care Coordination newsletter.

CMS Considers Overhaul to ACO Benchmarks

The federal government has rolled out an important proposal to revamp how Accountable Care Organization (ACOs) financial targets are set upon program renewal. The change influences whether an ACO, a health care entity composed of health care providers and hospitals coming together to coordinate care care for fee-for-service Medicare beneficiaries, may earn shared savings under program guidelines.

The rule, proposed by The Centers for Medicare and Medicaid Services (CMS), would shift from a national to a regional comparison model, readjusting the ACO’s benchmark from the prior performance period to reflect trends in fee-for-service costs for the ACO region. This is a departure from the current practice of updates based on national Medicare FFS spending for parts A and B Medicare.  The comment period for the rule closed March 28, 2016.

The benchmark is a reference point an ACO is measured against to determine whether Medicare fee-for-service costs were higher or lower than previous spending levels. It is a critical factor for calculating whether the ACO qualifies for shared savings.

National Rural ACO (NRACO) heard from its ACO participants that they are supportive of moving to the regional comparison model, arguing it will better reflect the health care environment in which the ACO operates.  The organization is seeking clarity from CMS regarding how its model of geographically-dispersed ACO participation would be evaluated under this model.  Read NRACO’s comment letter here.

This proposed rule is the latest of several program revisions since the program was enabled under the Affordable Care Act in 2010.   As of Jan. 1, 2016, there were are more than 400 ACOs participating in the Medicare Shared Savings Program, according to CMS, including the 23 that joined the program in 2015 through National Rural ACO’s participant network. The final rule is expected to be published this summer.

Essential Reading on the Future of MACRA and MIPS

Healthcare policy and future reimbursements are changing rapidly.  This is a terrific editorial and article that summarizes the future of the Medicare Access & CHIP Reauthorization Act (MACRA) and Merit-Based Incentive Payment System (MIPS).  In just over three years, MACRA will consolidate the Physician Quality Reporting System, Meaningful Use, and the Value-Based Payment Modifier into a single program that further promotes value-based care.  MIPS will negatively influence at least half of physician payments unless you fall under an Alternative Payment Model (APM) like an ACO.  Meanwhile, physicians in a qualifying APM will receive a 5% annual bonus between 2019-2025 and won’t face the performance bonuses/penalties under MIPS. Today, rural health clinics and FQHCs are exempt. The National Rural Accountable Care Consortium will continue to educate and advocate for rural providers as these changes develop over the next 3 years.


Article and editorial from the American Assoication of Family Physicians. (AAFP). All rights reserved.

Challenges and Advantages of Becoming an ACO

The Rural Health Information Hub uncovers the biggest challenges and advantages to creating an ACO.  Greg Paris, our VP and General Manager of ACO Services, delves into National Rural ACO’s successful progression over the course of three years, and reveals the uncertainties providers must look out for in the future of healthcare. This is essential reading for anyone interested in becoming an ACO.

Read the full article here.

Article courtesy of Rural Health Information Hub. All rights reserved.


Read Our February 2016 Care Coordination Newsletter

Quality of Life. We aim to arm Care Coordinators with a tool box of knowledge and resources so that they can provide the best care possible to their patients. Our February Care Coordination Newsletter delves into Chronic Obstructive Pulmonary Disease, covering various adjustments and treatments Care Coordinators can make to ensure patients living with COPD have an improved quality of life. We also share information about the COPD Foundation’s community website, which will provide Care Coordinators with an expanded network of information and support.

Click here to read our February 2016 Care Coordination newsletter.


Rural Providers Organized Under 23 Medicare ACOs Receive $46 Million AIM Funding From CMMI

I would like to share this news release which was released to the news media today.

Lynn Barr

Rural Providers Organized Under 23 Medicare ACOs Receive $46 Million AIM Funding From CMMI

Additional $31 million also provided by CMMI to prepare rural practices for value-based payments under new Practice Transformation Network

Nevada City, CA, January 12, 2016 — A pioneering group of rural physicians and hospital administrators came together in 2013 to begin the journey toward managing rural population health. Through innovation and collaboration, they sought to transform today’s rural healthcare delivery system into a world-class primary care system that provides professional satisfaction for clinicians, attracts consumers, and provides high-quality acute, post-acute and outpatient services that meet patients’ needs.

These rural thought-leaders joined forces to form the first National Rural ACO (NRACO) and create the NRACO Services Corporation (NSC), which has been supporting rural Medicare ACOs with training, data, analytics, patient satisfaction surveys, and evidence-based medicine programs since 2014. In 2015, NSC organized more than 6,000 providers in 159 rural health systems into 23 Medicare Shared Savings Program (MSSP) ACOs, and obtained $46 million in ACO Investment Model funding to support their ACO operations and local care coordination programs. This group includes 55 rural PPS hospitals, 92 Critical Access Hospitals, 168 Rural Health Clinics, and 39 rural FQHCs serving more than 500,000 Medicare patients.

Working with other key stakeholders like the National Rural Health Association and the National Rural Health Resource Center, the rural hospital CEOs also started the non-profit National Rural Accountable Care Consortium. The Consortium will assist hundreds of rural health systems in their journey toward accountable care, funded by a $31 million cooperative agreement award from the Center for Medicare and Medicaid Innovation (CMMI).

To date, the majority of National Rural ACO participants have demonstrated reductions in per capita spending while improving quality and patient satisfaction. Unexpectedly, this has also resulted in financially strengthening the majority of the participating rural health systems. Participating hospital CFOs are queried monthly on the financial status of their organizations, and none have reported negative effects of being associated with accountable care, while most have described increased revenue and improved staff satisfaction.

According to NRACO founding member Tim Putnam, CEO of Margaret Mary Health in Batesville, Indiana, “there will be significant opportunities to strengthen rural health systems by becoming an ACO or participating in a CMMI innovation model in the next 1-2 years, but providers must prepare.” Co-founder Melanie Van Winkle, CFO of Mammoth Hospital in Mammoth Lakes, California agrees, saying “this is the reason we exist, to take care of the community. The ACO helps us focus on our mission.” Steve Barnett, CEO of McKenzie Health in Sandusky, Michigan adds, “once you begin giving this type of care, you’ll never go back. We are very grateful for the support we have received from CMS, CMMI, MedPAC, and the Federal Office of Rural Health Policy. We wouldn’t be able to organize rural providers under this model without their help.”

Today, rural providers can get all of the support they need to be ready for value-based payments through the Consortium’s Practice Transformation Network, fully funded by CMMI. Medical office staff will be trained in population health management, including care coordination, quality improvement, annual wellness visits, and patient satisfaction, and can begin billing for these professional services.

Spaces are still available to join the Consortium’s Practice Transformation Network. In order to enroll in this federally-funded program that provides a population health infrastructure to rural practices at no cost, go to

Contact: Lynn Barr, Chief Transformation Officer



Read Our January 2016 Care Coordination Newsletter


It’s all about the patients. My favorite part of the month is when our monthly care coordination newsletter is published. I jump right to the back to read about the individuals whose life has been changed by their care coordinator. Care Coordinators are my heroes. In this month’s issue, we hear about how team-based approaches are breaking down barriers with patients, how care coordinators help non-adherent patients change their habits, how patients are using self-management tools to avoid hospitalizations and how care team members work to overcome financial barriers to health.

Click here to read our January 2016 Care Coordination newsletter. I hope you enjoy it.

Thank you Care Coordinators, and thank you Clinicians and hospital Administrators for supporting this important work.