On Tuesday, August 11, leaders at the Washington, D.C.-based National Association of ACOs (NAACOS) praised an announcement coming out of the federal Centers for Medicare & Medicaid Services (CMS) aimed at helping rural providers to move to alternative payment models (APMs), including accountable care organizations (ACOs).
As Senior Editor David Raths reported in a news article on Aug. 11, “The Centers for Medicare & Medicaid Services (CMS) Innovation Center has announced the Community Health Access and Rural Transformation (CHART) Model, which seeks to help rural providers by reimbursing upfront investments and offering predictable, capitated payments that pay for quality and patient outcomes. CMS notes that the approximately 57 million Americans living in rural communities face limited transportation options, shortages of healthcare services, and an inability to fully benefit from technological and care-delivery innovations,” he wrote.
As Raths noted, “The CHART Model aims to: increase financial stability for rural providers through the use of new ways of reimbursing providers that provide up-front investments and predictable, capitated payments that pay for quality and patient outcomes; remove regulatory burden by providing waivers that increase operational and regulatory flexibility for rural providers; and enhance beneficiaries’ access to healthcare services by ensuring rural providers remain financially sustainable for years to come and can offer additional services such as those that address social determinants of health including food and housing.”
Following that announcement, in a press release posted to the association’s website, NAACOS president and CEO Clif Gaus, Sc.D. stated that “Today’s announcement from the Centers for Medicare & Medicaid Services (CMS) on helping rural providers move to alternative payment models is a needed and welcomed step for our health system’s move to value-based payment. The ACO Transformation Track offers resource-deprived rural providers a helping hand to invest in the tools needed to build accountable care models, including health IT, data analytics and care managers. NAACOS has for the last couple of years encouraged CMS to restart the ACO Investment Model, on which today’s ACO Transformation Track is based. The ACO Investment Model has been one of the most successful models from the CMS Innovation Center, saving Medicare $382 million over three years and helping start new, successful and long-lasting ACOs. NAACOS thanks CMS Administrator Seema Verma and CMS Innovation Center Director Brad Smith for their leadership on this issue.”
Gaus’s statement continued, “Another way to support rural providers in ACOs would be for CMS to address a flaw in how CMS sets ACO spending targets (i.e., benchmarks) to ensure rural ACOs are not disadvantaged compared to other ACOs. Often referred to as the ‘rural glitch,’ NAACOS has long called for CMS to fix its benchmarking methodology. In addition to providing new opportunities to rural providers, NAACOS calls on CMS to continue expanding the progress of ACOs by allowing new ACOs to join the Medicare Shared Savings Program (MSSP) in 2021. Earlier this year the agency canceled a new 2021 MSSP ACO class due to challenges with the ongoing COVID-19 pandemic.”
The statement went on to say that “ACOs have demonstrated that they are uniquely equipped to respond to the pandemic, and our health system needs more accountable care models and participants today given their ability to help provide high-quality, preventive, coordinated care. For example, ACOs have used their population management systems and other tools to educate patients about minimizing exposure, make sure they have enough food and medication to stay home, remotely monitor their underlying conditions, treat cases through telemedicine, and manage post-discharge complications with integrated home health and effective relationships with post-acute providers. NAACOS looks forward to working with CMS and providers interested in the new rural accountable care opportunities while also advocating for and supporting existing ACO models.”
As explained on its website, “The National Association of ACOs (NAACOS) is a 501 (c) 6 non-profit organization that allows Accountable Care Organizations (ACOs) to work together to increase quality of care, lower costs and improve the health of their communities. Determined to create an environment for advocacy and shared learning, hundreds of ACOs with millions of lives from all 50 states and the District of Columbia formed NAACOS.”
