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What We’re Watching: July 23, 2019

NOT EXACTLY POP CULTURE

CMS approved 206 ACOs for participation in the Medicare Shared Savings Program (MSSP) starting July 1, bringing the total number to 518 MSSP ACOs. This class of MSSP ACOs is the new Pathways to Success, which accelerates providers’ requirement to take two-sided financial risk. Meanwhile, a study of rural MSSP ACOs participating in the first year of the ACO Investment Model shows they reduced Medicare spending by more than $28 per person compared to non-ACO spending, with a total savings of nearly $50 million.

What we’re saying: Notably, the number of MSSP ACOs taking risk has increased to 29 percent and of those, the ones that started in 2012 or 2013 took on risk at a much higher rate. This tells us that more experience in a no-risk model better paves the way to taking on two-sided risk. When implemented effectively, these models are working – even for rural ACOs. We’re seeing this firsthand as 11 percent (59) of the new class of ACOs are members of Premier’s Population Health Management Collaborative and all of them who came due to renew chose to do so. Premier collaborative members continue to substantially outperform the rest of the country by approximately 30 percent in achieving shared savings.

HOME IMPROVEMENT

On July 11, CMS issued its proposed rule that makes changes and updates to calendar year 2020 home health payment rates, implementation of the Patient-Driven Groupings Model (PDGM), the Home Health Value-Based Purchasing (HHVBP) model, home health quality reporting requirements and home infusion therapy payment rates for the temporary and permanent services benefits.

What we’re saying: Join our webinar on Thursday, July 25, to hear Premier's Shara Siegel, M.S. Director of Government Affairs for Premier/Innovatix, and Brad Kile, Ph.D. President of the Dumbarton Group take a deeper look at the rule.

WE’RE ON IT

Results from a Medicare Advantage customer satisfaction survey found overall satisfaction rose compared to 2018. Timely news as healthcare industry leaders convene this week representing plans, providers, patients and government at the Better Medicare Alliance Summit to improve quality, cost and access in Medicare Advantage.

What we’re saying: We’re focused on helping providers succeed in Medicare Advantage as it continues to grow with roughly 35 percent of Medicare beneficiaries now enrolled. In fact, we’re working with John Gorman to do just that. But we also have ideas on how Congress and the administration can boost competition to lower drug prices and advance value-based care in Medicare, and we’ve been walking the talk for years. That’s why we have feet on the ground at the Better Medicare Alliance Summit.

  • Our drug policy guru, Soumi Saha, PharmD, JD, Senior Director of Advocacy, will participate in a panel titled “Part D 2020: Modernization of Part D & Data-Driven Tools to Improving Drug Therapy Management,” and share Premier’s recommendations for Congress and the Administration
  • Aisha Pittman, MPH, Senior Director of Policy, will join in the discussion, “Navigating Value-Based and Risk Sharing Agreements: Payors and Providers Partnering to Improve Care”

IN CASE YOU MISSED IT

What We’re Watching is a weekly blog focused on the current events Premier is following and their relevance to the work of Premier and its members. Check out last week's update.

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