To kickoff 2020, The National Association of Accountable Care Organizations (NAACOS) hosted an intimate bootcamp on February 24th and 25th in Orlando, FL. The conference was well-attended by more than 100 individuals, and the overarching theme was Mastering Fundamentals. Interestingly, the attendees were primarily from ACOs that were participating in Pathways to Success under Basic B, followed by those still on Medicare Shared Savings Program (MSSP) Track 1. This means the majority of the attendees were yet to take on downside risk, and this conference was an opportunity for them to prepare to do so.
Bootcamp is a bit different from the typical NAACOS Spring and Fall conferences. At bootcamp, the focus is on giving attendees a chance to discuss granular programmatic details and best practices. The Spring and Fall NAACOS conferences are significantly large, with a focus on high-level value-based care topics and policy. Because of this, bootcamp tends to lend itself to a more intimate learning environment. This year, the bootcamp was focused on the topics of leadership buy-in, leveraging risk adjustment, and identifying and implementing best practices for ACO essentials. The speakers were composed primarily of an engaging group of NAACOS Board members. Their long-term experience in the field gave these subjects lots of perspectives. As usual, I left the conference with plenty of notes to take back to our team.
Our own Maria Nikol, MJ and I were invited to speak on the topic of effectively using the data that’s available to ACOs. This topic was shared with Jennifer Perloff who was able to provide in-depth information on B-CAPA, created by the Institute for Accountable Care. We found that it would be a good contrast for the Salient team to discuss all of the different sources of data available to ACOs, the security required for personal health information (PHI), the transfer and storage processes, data enrichment examples, and the key performance indicators (KPIs) that can be used across the organization at the practice and provider levels for continuous process improvement. This discussion created a baseline of understanding of ACO data, and Ms. Perloff rounded it out to show how the entire Medicare database can help with both benchmarking and comparisons to create applicable initiatives. Interestingly, the B-CAPA data includes post-acute care data that can be instrumental in building preferred provider networks.
Because I found the content during this conference to be detail dense, I wanted to provide you with my four biggest takeaways:
- While Medicare Advantage enrollment has nearly doubled over the past decade to account for 34% of Medicare beneficiaries in 2019, regular Medicare will continue to exist.[1] Value-based programs will continue to flourish and evolve.
- Medicare ACO Claim and Claim Line Feed (CCLF) data will continue to be the most robust set of data, and it becomes extremely valuable to use for commercial contract negotiations.
- Previously, ACOs were reluctant to engage specialists, mostly due to attribution complications. However, However, specialists are now taking a front seat in ACO workflows to ensure smooth transitions of care and management of chronic conditions. Many ACOs are now working with specialists to design preferred provider networks to identify high-value networks. One of the strategies that was discussed during bootcamp was to host a meeting between the specialists and primary care providers to identify processes and best practices; compacts were strongly encouraged.
- Even if you have trained your providers to properly and accurately code, there can be a mismatch in the CMS results which can be accounted for by either the EMR billing submission or the clearinghouse. Therefore, the entire submission of codes from end to end must be analyzed to ensure no break in the chain.
As is the case with most NAACOS
events, Bootcamp 2020 was executed exceptionally, and the networking and
educational opportunities were tremendous. We hope to continue to be a part of
this excellent experience, and we will surely apply some our takeaways to our
solution and offerings. Accountable Care Organizations have rules they must
abide by, and program directors need to know them inside and out…and FAST! As
value-based care evolves rapidly, there is no time to make mistakes with Pathways
to Success. Risk is around the corner, and the training wheels are going to be
stripped off faster than you think.
[1] https://www.kff.org/medicare/issue-brief/a-dozen-facts-about-medicare-advantage-in-2019/
