Complimentary from the publisher

Complimentary from the publishers of Accountable Care News April 2021

"We want CMS to move forward with the Direct Contracting Model and with the risk-sharing arrangements in Next Gen ACOs. We’re interested in all of the models, frankly. That’s why we say to Medicare, ‘Let’s go forward with these models.’ "
- Don Crane, J.D., President and CEO, America’s Physician Groups (APG).

In 2018, 22% to 36% of beneficiaries in traditional fee-for-service Medicare received at least one low-value service, and Medicare spending for those services ranged from $2.4 billion to $6.9 billion, according to the March 2021 Report to the Congress by the Medicare Payment Advisory Commission.

Source: Accountable Care News, Volume 12 Number 4, April 2021, Washington DC Watch: "MedPAC’s Value Recommendations Date to 2012."

	Theresa Hush: 5 Behavioral Health Strategies for ACOs and Medical Group Models 1. Create models for behavioral health integration in primary care that the ACO/Medical Group can support with resources and data. 2. Adopt ACO/Medical Group technology, with data collection standards, to support Behavioral Health Integration. 3. Implement ACO/Medical Group Behavioral Health assessments and reach consensus on pathways to treatments and referrals. 4. Implement training curricula across all practices, including cross-training strategies between behavioral health and primary care clinicians. 5. Establish outside Behavioral Health referral sources for patients that require specialized expertise or facilities, or care that cannot be provided inside the practices through behavioral health integration. Source: Roji Health Intelligence, April 5, 2021
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How cutting off subsidy payments to insurance companies would affect Obamacare

CMS ACO Reporting & End of Web Interface: Transitioning to the new APM Performance Pathway

CMS announced the end of the Web Interface mechanism in the 2021 Final Rule and introduced the new APM Performance Pathway (APP). This means organizations will need to adjust their participation in the Quality Payment Program by 2022. Mingle Health experts share the steps required to make the transition away from the Web Interface mechanism and the capabilities necessary to make the process as smooth as possible.

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Whither the ACO?
Managed Healthcare Executive, April 16, 2021

14 organizations urge HHS to extend Next Generation ACO model
Becker's Hospital Review, April 14, 2021

To Sustain The Value Movement, Make Next Generation ACOs A Permanent Option
Health Affairs Blog, April 9, 2021

Provider Perceptions of Pharmacists in Primary Care–Based ACOs
The American Journal of Accountable Care, April 7, 2021

Solving the ACO’s Out-of-Network Utilization Problem
RevCycle Intelligence, March 29, 2021

NAACOS calls for Becerra to stem losses in ACO participation
FierceHealthcare, March 22, 2021

With Competing Payment Models On Hold, What’s The Future For ACOs?
Roji Health Intelligence, March 18, 2021

The one-year impact of AC networks among Washington State employees
Health Services Research, abstract only, April 16, 2021

Findings From a Commercial ACO Patient Experience Survey
Journal of Patient Experience, April 7, 2021

Integrating behavioral health and primary care
Medical Economics, April 5, 2021

The Effects of ACOs Forming Preferred Skilled Nursing Facility Networks
Medical Care, abstract only, April 2021

Do ACOs differ according to physician-hospital integration?
Medicine, March 26, 2021

News @ Deadline: Fallon Health Continues Focus Shift to Medicare, Medicaid – Including ACOs; Organizations Form Shared Savings Entity Under State’s PASSE Program; Paradigm, SRALab in ‘First-of-Its-Kind’ Value-Based Partnership’
Washington DC Watch: NAACOS Gives New CMS 2 Thumbs Down, Calls for More ACO Support; Letter to Becerra: CMS Must ‘Grow Medicare ACO Program’; MedPAC Emphasizes APMs to ‘Incentivize Clinicians to Deliver Care More Efficiently’; MedPAC’s Value Recommendations Date to 2012; Payment Rate Updates Under MIPS Pass Muster; MedPAC Counts the Ways to Support AAPM Waivers for TelehealthCommissioners Cautious About Telehealth; AAPM Providers Get More Leeway
CareCentrix Model Lowers Costs ‘Significantly’
ACO Performance: PatientPing ACOs ‘Earn $264M in Savings Under Next-Gen Model’; Apollo’s ACO ‘Achieves $20M in Shared Savings in Next-Gen Program’
Industry News with briefs regarding CareSource and the Ohio Association of Community Health Centers; Change Healthcare; Independence Blue Cross and Quartet Health; Commonwealth Care Alliance and the Community Pharmacy Enhanced Services Network; UST, HealthEdge, and Gateway.


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