July 13, 2017

ACO roundup: MedPAC urges CMS to streamline MIPS reporting requirements

Daily Briefing
    • CMS delays home health agency rules by 6 months. CMS on Friday finalized its proposal to delay by six months the effective date of a final rule that will set new standards for home health agencies (HHAs). The final rule, issued in January, details new training requirements, competencies, and patient rights criteria HHAs must follow to participate in the program. CMS' latest action finalizes the agency's April proposal to delay the rule, with the effective start date now postponed from July 13, 2017, to Jan. 13, 2018. CMS also finalized its proposed changes to the date by which HHA administrators must have been hired by the facilities to be exempt from the rule's personnel requirements and its proposed delay of the phase-in date for data-related performance improvement project requirements under the final rule. CMS said it would publish interpretive guidance for the final rule in December 2017.

    • Why health systems are seeking out executive talent to drive population health. As hospitals and health systems transition from fee-for-service to value-based payment models, population health is becoming more of a focus—and health systems increasingly are hiring senior executives to manage the health of entire communities. For instance, Akron Children's Hospital hired Kristene Grayem as its VP of population health management, while MetroHealth last year hired Nabil Chehade to be its SVP of population health and Summa Health made Mark Terpylak SVP of population health. Officials at the hospitals and health systems said they are creating and staffing such roles to break down silos between existing divisions and establish the infrastructure for a broader shift to value-based payments.

    • MedPAC recommends changes to MIPS track under MACRA. The Medicare Payment Advisory Commission (MedPAC) in its June report to Congress said federal policymakers should make changes to MACRA's Merit-based Incentive Payment System (MIPS) track that would reduce administrative burdens and place greater emphasis on patient health outcomes. Among other concerns, MedPAC in the report said MIPS currently does not differentiate between high- and low-performing provider practices, which could mean that small variations in providers' quality scores result in drastically different bonus payments, and that MIPS' 275 quality measures assess standards of care and provider processes instead of directly focusing on patient outcomes. To address those issues, MedPAC recommended that CMS increase its use of population-based outcome measures under MIPS and rely more heavily on claims data than on provider reporting and survey results.

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    • Is your Medicare risk strategy MACRA-ready? While the GOP's health reform effort continues to evolve, Medicare payment reform has quietly marched on with bipartisan support. And with MACRA well underway, the new administration has shown no signs of reversing course. As a result, hospital and health system leaders need to develop an intentional Medicare risk strategy today. Check out our new research report to learn how to navigate the Medicare ACO programs, expand into the Medicare Advantage market, and ensure the longevity of your Medicare risk strategy by actively cultivating contracts over time.

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    • How to build the easy-to-use consumer loyalty platform. Join us on Friday, July 21, in the first of a two-part webconference series exploring how to establish durable relationships with health system enterprise through a combination of simplicity, value, and trust. This initial presentation focuses on the first step of building durable patient relationships—establishing a simplified, connected consumer platform.

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