August 23, 2018

ACO roundup: CMS will cover some home visits for Next Gen ACOs

Daily Briefing
    • CMS says it will cover some home visits for Next Gen ACOs in 2019. CMS this month announced that beginning in January, the agency will reimburse Medicare contractors for eligible care management home visits under the Next Generation ACO model. Under the change, Next Generation ACO participants and preferred providers who oversee beneficiaries' care treatment plans can receive up to two care management home visits within 90 days of a patient visit. The change applies to the third year of the Next Generation ACO model.

    • Navigating post-acute care after his wife's car accident was a 'nightmare.' So this CEO got to work. A few months before Terry Shaw became CEO of Adventist Health System, he got a call that his wife, Paula, was unconscious in the ED, after a truck collided with her pickup. Paula recovered from the accident—but the "nightmare" the Shaws experienced navigating post-acute care inspired Terry to launch a care navigation program at his own system. In May 2018, Adventist launched a care navigation program aimed at helping patients and caregivers with discharge instructions, appointment scheduling, and getting prescriptions.

    • Vermont ACO launches 1-night hospital-stay waiver program. To improve care coordination between hospitals and skilled nursing facilities (SNFs), OneCare Vermont, a statewide ACO in Vermont, launched a waiver program that permits participating SNFs to accept Medicare beneficiaries after a one-day hospital stay. According to McKnight's Long-Term Care News, Medicare beneficiaries typically must be at a hospital for a minimum of three consecutive days before Medicare covers SNF treatment.

    From Advisory Board:

    • MPFS: How Medicare wants to pay providers in 2019. Join us on Wednesday, August 29, at 3:00 p.m. ET to learn about the 2019 Medicare Physician Fee Schedule proposed rule—including major changes to Medicare's approach to telehealth, a new bundled payment model for treating opioid-use disorders, reimbursement cuts for some prescription drugs, and more.

    Register Here

    • Your guide to the Meaningful Use (MU) overhaul. Join us on Thursday, August 30, at 1:00 p.m. ET to learn the key points of the finalized MU overhaul, how the PI Programs fit into the broader CMS quality reporting landscape, and action items for all providers impacted.

    Register Here

    • Learn the key details of CMS's proposed ACO overhaul. Join us on Tuesday, September 11, at 3:00 p.m. ET to learn about the proposed changes, what this means for the future of value-based care, and how the changes intersect with MACRA.    

    Register Here

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