NAACOS Fall 2019 Recap: The Future is Now

From September 25th – 27th I did what I’ve done every fall for the last few years: join Team Salient at the NAACOS Fall Conference. Dr. Craigan Gray (Medical Director), Jack Bloise (SVP and GM), Amy Kotch (Senior Business Consultant, Team Lead), Maria Nikol (Senior Business Consultant), Tiffany Smith (Senior Data Analyst), Stephanie Rotolo (Business Development Specialist), Wendy Teta (Office Manager/Marketing Specialist), and I made the trek to the Marriott Wardman Park in Washington, DC to join over 600 other professionals who work in healthcare administration with a focus on Value-Based Care. 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.

This year we didn’t have any late-breaking regulatory chaos to contend with, so much of the discussion was pre-planned and expected. During the last two Spring and Fall conferences, Pathways to Success was either just being announced or about to go into effect. Prior to that, there was still tension among the Track 1 ACOs stemming from the pressure they were feeling to take on downside risk. Now that they’ve learned that it’s inevitable, I think we’ve moved past the worry and into the realm of “okay let’s just get this done right.”


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As always, there was a slew of excellent seminars, and I would be remiss not to mention the Thursday morning breakfast session hosted by Salient Healthcare and Holy Cross Physician Partners (HCPP) ACO titled “Post-Acute Care Pathways: A Case Study on Network Utilization.”[RM1]  Maria and HCPP’s Executive Director, Kelly A. Conroy, put on an informative retrospective analysis on how network management can go a long way towards saving your ACO money while still providing high quality healthcare. We’re proud to say it was well-attended, and if you missed it, just click the presentation title above to be taken to a page where you can request a copy of it for yourself.

Other seminars I truly enjoyed included the opening plenary, “Private Payer and ACO Efforts to Transform Health Systems” hosted by Dr. Will Shrank, the CMO for Humana. Dr. Shrank expressed that while ACOs are truly driving the effort to eliminate waste and unnecessary care, we need to get a grip on big pharma and facilities if we’re ever to truly bring healthcare costs down and that more transparency will help. He also spent a lot of time talking about how we all need to come together to succeed by improving referral patterns data use, and proper care management. The transparency sentiment was echoed by Dr. Elizabeth Rosenthal, author of An American Sickness: How Healthcare Became Big Business and How You Can Take it Back. Dr. Rosenthal’s stories about how prescription drugs continue to increase in price as they age and how facility fees sometimes cost more than the actual procedure help shine a light on some of the other challenges facing our healthcare system today. Tie that in with Social Determinants of Health (Dr. Shrank mentioned that, “60% of what creates health has to do with the interplay between our socio-economic and community environments as well as lifestyle behaviors.”), administrative waste, physician burnout, and overutilization of the ER, you have quite the storm of healthcare issues to battle. Thankfully most of the healthcare professionals I spoke with are more than motivated to rise to take on the challenges that face us.

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I also want to mention other valuable seminars like “Actuarial Insights into ACO Composition and Approaches to Maximize Shared Savings” by Colleen Norris and her colleagues at Milliman where they discussed that the right balance of clinical personnel for each ACO will vary from population to population. Another seminar I enjoyed was “Social Determinants of Health: Moving Beyond Screening to Community Partnerships” presented by a panel of Midwest ACO experts including Caitlin Dunn of Froedtert & the Medical College of Wisconsin where they focused on the value of the community that their beneficiaries lived in.  There are always so many great presentations that make NAACOS’ bi-annual conferences so enjoyable.  If you attended the conference, you can download the presentations on the NAACOS website, so if you missed any of the above I think they’re worth taking another look at.


The takeaways from NAACOS Fall 2019 are that while there are still skeptics that Value-Based Care can work, we’ve really started to see some real traction. In fact, shortly after NAACOS it was announced that CMS saved $739 million last year from Medicare ACOs. According to Modern Healthcare, just over 82% of ACOs were Track 1 this past year, which is down from 92% in 2017 which shows that the move toward taking on downside risk is slow, but it is happening.

All of this information fuels Value-Based Care professionals because we know it takes time to build momentum, but we’re starting to see some payoffs. I look forward to the NAACOS Spring 2020 Conference in Baltimore next year. I fully expect to see more discussed about Medicare Advantage, a continued emphasis on network management, and an even greater focus on managing risk as even more ACOs will be moving down that Pathways to Success glidepath towards downside risk.


It wouldn’t be a NAACOS conference without a little fun. What, you thought we just educate ourselves the entire time? Following our pre-conference seminars on Wednesday, Team Salient had the opportunity to bring a few ACOs out to see the Washington Nationals host the Philadelphia Phillies at Nationals Park. It turned out to be a great game since Washington is now in the playoffs, and everyone had a lot of fun. This was our second time doing a ballgame event and the turnout continues to grow. Thanks to everyone who came, and we’ll see you in April at Camden Yards for what I believe will be Opening Day.

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Ryan Mackman

About the Author

Ryan Mackman, MBA, MHA - Business Consultant

Ryan Mackman has been an ACO business consultant team member with Salient since March 2018. In this role, he acts as a solution trainer, marketing and sales consultant, as well as Value Based Payment strategist. His skillset helps augment Salient’s efforts at the ACO and physician practice level.

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