July 19, 2018

ACO roundup: UnitedHealth Group projects its ACO enrollment to 'double'

Daily Briefing
    • Azar picks CMMI director to lead value-based care efforts. HHS Secretary Alex Azar this week appointed Adam Boehler, who currently serves as the director of the Center for Medicare and Medicaid Innovation (CMMI), to serve as HHS' senior advisor for value-based care initiatives. Boehler will serve in both of his roles concurrently. Azar said of the appointment, "At CMMI, [Adam] has already demonstrated an ambition for bold change, and will now be able to bring his deep experience with private sector innovation to help HHS execute on the long-talked-about goal of transforming our [health care] system into one that pays for value."

    • UnitedHealth Group projects its ACO enrollment to 'double'. UnitedHealth Group (UHG) this week said its national ACO, NexusACO, will likely double in size as self-funded employers look for less costly health benefits. According to UHG, UnitedHealthcare—UHG's insurance arm—launched NexusACO in 2017 for self-funded employers with at least 100 employees. NexusACO now works with 33 ACOs in 15 states, covering about 75,000 enrollees, and UnitedHealth Group CEO Dan Schumacher on Tuesday said the company projects that enrollment will "double … as we turn into the year and [will] … double that again by the time we get to the end of 2019." (The Daily Briefing is published by Advisory Board, a division of Optum, which is a wholly owned subsidiary of UHG. UHG separately owns UnitedHealthcare.)

    • How CMS wants to change MACRA's QPP in 2019. CMS last week released a proposed rule with policy updates for year three of MACRA's Quality Payment Program. CMS in the rule proposed changes to reduce clinician burden, emphasize patient outcome measures, and promote EHR interoperability. Overall, CMS estimated that changes in the QPP proposed rule, if finalized, would save clinicians a total of 29,305 hours and reduce administrative costs by about $2.6 million in 2019. CMS is accepting public comments on the proposed rules until Sept. 10.

    From Advisory Board:

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    • The 2018 MIPS cost category—decoded. Join us on Thursday, August 2, at 3:00 p.m. ET, to learn the metrics included in the 2018 MIPS cost category, how providers' scores will be calculated, and strategies for improving performance.

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    • How to succeed under Medicaid risk. Join us on Tuesday, August 14 at 1:00 p.m. ET for a live panel discussion with population health, health plan, and Medicaid strategy experts from within Advisory Board to learn about key considerations for taking on Medicaid risk and setting up the right infrastructure to manage the population.

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