From October 3rd-5th I had the pleasure of joining our ACO team comprised of Jack Bloise (General Manager), Dr. Craigan Gray, MD, JD, MBA (Medical Director), Lisa Ryan (VP of ACO Services), Amy Kotch, MHA (Lead Business Consultant), Helene Ravert (Principal Data Analyst), and Brendan Boris (Director of Marketing) at the Fall 2018 NAACOS conference near Capitol Hill in Washington, DC. Salient is proud to be a part of NAACOS’s Partner Circle in a collaborative effort to identify legislative and operational challenges for Accountable Care Organizations (ACOs) as well as improve ACO performance.
Plenty was learned, discussed, and debated at the multitude of seminars spanning across topics such as, “Building a Network of Specialists,” “Evaluating the Private Payer ACO Landscape,” and “How to Succeed as a Physician-Led ACO.” Of course I would be remiss not to mention our own Dr. Gray and Amy Kotch presenting “How One ACO Untangled a Web of Data to Prepare for Risk” in conjunction with Holy Cross Physician Partners ACO from Fort Lauderdale, FL. Naturally, the topic of conversation frequently skewed towards discussing CMS’s new Pathways to Success initiative.
Pathways to Success proved to be as polarizing as I expected. Several executives scoffed at how the proposed BASIC Track (which is replacing Track 1, Track 1+, Track 2, and Track 3) starts with a 25% shared savings rate through Levels A and B rather than 50%. One executive even mentioned that if he had to start at 25% savings when he first began his ACO, his organization wouldn’t even exist today. They used the money as investment capital for the organization while the rest were provided to the physicians that made large efforts in changing the way they were practicing medicine.
Another point to note is that those ACOs with start dates in 2017 and 2018 have the option to file extensions to be grandfathered in, allowing them to stay with the “old” rules before jumping into Pathways to Success. During a Track 1 ACO breakout session, a few administrators admitted they planned on doing so.
Many ideas were tossed around as potential adjustments to the proposed new legislature, including the creation of special MSSP models for unique populations such as beneficiaries in rural areas or with HIV, etc. Another administrator felt that all ACOs in their first two years (if they sign a longer contract) should have a shared savings rate of 75%, giving them a chance to provide their organizations with more revenue for infrastructure investment, ultimately leading to long-term business growth.
During one plenary, Katherine Schneider, MD, President and CEO of Delaware Valley ACO and Chairman of the Board of NAACOS, mentioned, “Our focus today is to shift from MSSP and its offshoots and speak about our relationship with private payers.” Getting involved in private insurance, like Medicare Advantage, is certainly a viable option to continue value-based care. Ultimately, we will have to see what transpires following a pivotal three-day event.
No matter what direction Administrator Seema Verma and the rest of CMS choose to go in, Salient Management Company is standing by to help ACOs adjust to a shifting healthcare climate. Whether it be Spend, Quality, Utilization, or even Social Determinants of Healthcare, our dashboards, data analysis solution, and team of consultants are ready to help ACOs navigate treacherous waters and continue to realize shared savings when their providers deliver high-quality, low-cost care.
Didn’t get a chance to see our presentation? View it here!