NAACOS Spring Recap – Prepare for Risk

On April 24-26, I had the pleasure of joining our the Salient Healthcare team at the Spring 2019 NAACOS conference in Baltimore, MD. 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.

I enjoyed the collaboration, networking, and learning. The topics included a multitude of seminars spanning across policy, clinical, and administrative perspectives. It was great to confirm our understanding and strategy through seminars such as: Adapting Your ACO to CMS’s Latest Rule, New Frontiers in Achieving Value in Post-Acute Care, and ACO Physician Engagement: Strategies for Driving Clinical and Financial Outcomes from Within. Per our annual tradition, Salient Healthcare hosted a breakfast panel discussion. This year’s topic was the “MA and MSSP Crossover,” examining the similarities and differences across patient populations, resources/infrastructure for maintenance and management, and contract negotiation. The speakers on the panel included: David Klebonis, COO Palm Beach ACO; Katie Herron, MS, Director Network Operations, Vanderbilt Health Affiliated Network, and Craigan Gray, MD, JD, MBA, CMO Salient Healthcare.

CMS Administrator Verma opened the conference following CMS’s Monday announcement regarding the new CMS Primary Cares Initiative. Today, only 10 percent of clinicians are participating in Advanced Alternative Payment Models due to the complexity of models, difficulty of obtaining data, and a limited number of models to enroll in. She was clear that participation in risk-based models would be mandatory in the future, stating “Requiring participation also helps us understand the impact of our models on a variety of provider types, so the data resulting from the model will be more broadly representative.”

While Seema Verma didn’t provide specific details about the models, NAACOS invited Pauline Lapin, Director of the Seamless Care Models Group at the CMS Innovation Center to speak at an unplanned session to help explain the new CMS Primary Cares Initiative models. There will be two initiatives that offer five options to primary care providers: Primary Care First and Direct Contracting. She explained that there will be varying degrees of risk in these models, aimed to encourage providers to improve on quality and lower costs through bonuses and penalties. In all models, providers will receive fixed payments based on their population of Medicare beneficiaries.

No matter what direction Administrator Seema Verma and the rest of CMS choose to go in, Salient 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.

Maria Nikol

About the Author

Maria Nikol

Maria Nikol is a senior business consultant with 10 years of experience in healthcare operations and healthcare strategy. Her specialization includes process improvement and the application of emerging models of healthcare delivery such as Patient-Centered Medical Homes and Accountable Care Organizations. She holds a Master of Jurisprudence in Health Law from Widener University and a Bachelor of Science in Pharmaceutical Marketing and Management from the University of the Sciences in Philadelphia.

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