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GE Healthcare Camden Group Insights Blog

New Download: Considering the Next Generation ACO Model

Posted by Matthew Smith on Apr 8, 2016 8:52:37 AM

Download, PDF, NGACOCMS recently launched the first step of the application process for its Next Generation ACO (“NGACO”) Model. The NGACO, CMS’ newest two-sided risk model, accepted 21 organizations for 2016.

Our 7-page PDF document, Considering the Next Generation ACO Model, includes information explaining and highlighting:

  • Model Highlights
  • Risk Arrangements
  • Payment Mechanisms
  • Timelines
  • Our Experience
  • Our ACO Services

To download this document, please click on the button below.

Next Generation ACO

Topics: Download, Next Generation ACO Model, NGACO

MSSP and NGACO Application Windows Quickly Approaching

Posted by Matthew Smith on Apr 6, 2016 11:50:17 AM

By Daniel Juberg, Manager, GE Healthcare Camden Group

ACO News, MSSP, NGACOCMS recently launched the first step of the application process for its Next Generation ACO (“NGACO”) Model, and next month opens the window to apply for the Medicare Shared Saving Program (“MSSP”) Initiative. The NGACO, CMS’ newest two-sided risk model, accepted 21 organizations for 2016. The MSSP, which also added enhanced risk-based options in 2016, had 100 new ACO participants this year, bringing the total to 434 ACOs at the start of the year. These numbers reinforce CMS’ stated goal to move 30 percent of traditional Medicare fee-for-service payments into alternative value-based payment models by 2016, and 50 percent by 2018.

MSSP: Zero Downside Risk

The MSSP Model was introduced in 2012 as a key component of the Medicare delivery system reform initiatives found in the Affordable Care Act and a new approach in the delivery of health care intended to facilitate coordination among providers to improve the quality of care. Among the primary attractions of the MSSP was the option to participate with zero downside risk, meaning if organizations outspent their target expenditures, they would not be liable to repay the difference to CMS. Through Track 1 there existed only upside, or the ability to share in any savings generated, an appeal that the MSSP Model maintains to this day. This allows organizations to dip their toes in the accountable, value-based waters and develop the infrastructure necessary for future success while still participating in a fee-for-service environment today. And the participating organizations have largely voiced their approval of the program – more than two-thirds renewed their participation when their initial agreement ended in December.

NGACO: Higher Risk/Higher Rewards

While the MSSP Model was the right first step for many organizations beginning their journey towards value-based care, it was in many ways insufficient for more advanced organizations experienced in care management and risk-based contracting. Thus the Next Generation ACO model was born, providing a higher-risk, higher-reward alternative to the MSSP, while simultaneously responding to and improving upon its oft-maligned and challenged predecessor, the Pioneer Model, with a refined attribution process and enhanced benchmarking methodologies. Now organizations can select between two risk options from 80 to 85 percent on the shared savings option all the way to a full-risk opportunity. Now if organizations overspend their benchmark expenditures, they will have to cut CMS a check at the end of the year. This may seem daunting, but many organizations view this as the natural programmatic evolution and that the increased skin in the game can be the push their organization might need to really enact the necessary transformation. In fact, seven of the new NGACO participants came from the MSSP program, demonstrating the interest of existing program participants to advance their risk exposure and opportunity based on their work and success to date.

The NGACO, with its enhanced risk profile, is obviously not for everyone, which explains why only 21 were accepted in the past cycle. As stated above, the NGACO was effectively developed for those organizations with experience in commercial ACOs or with value-based contracts, or that had experienced success in the MSSP and had outgrown the less-lucrative risk arrangement. Accordingly, in addition to the seven MSSP converts to the NGACO program, eight made the transition from the similarly two-sided, but less favorable Pioneer model.

Deadlines Approaching

The good news for organizations wanting to prepare for a value-based future is that the 2017 application windows for both programs are upon us. Organizations contemplating their fit in either initiative can apply for one or both, but need to submit their Notice/Letter of Intent by the respective deadlines to be considered. These submissions are non-binding, so we encourage organizations at all considering participation to file one and then assess their options in the next few months. One caveat is that while organizations can simultaneously apply for both models, they will ultimately only be able to participate in one of the two initiatives.

The NGACO Letter-of-Intent is due May 2, with the MSSP Notice-of-Intent due May 31. Additional key milestones for both models can be found below:

NGACO_Milestones.png

With the continuous innovations of both payment and delivery models, CMS is maintaining its commitment to the transformative shift to value-based care. While that momentum is undeniable, not all organizations are necessarily ready for that transition just yet, particularly in the riskier models. We recommend undergoing a comprehensive (and candid) self and market assessment of your organization’s present situation and evolution in what GEHC Camden Group considers the eight core domains essential for clinical transformation to successfully thrive in a value-based world. A commitment must be demonstrated in the below key operational competencies in order to achieve success in the changing landscape.

Key_operational_competencies.png

CMS has reiterated its commitment to population health with its ongoing development and support of these accountable initiatives. Even more encouraging, CMS has demonstrated a willingness to adapt and improve to encourage participation and collaboration. The strongest healthcare organizations tend to be the ones that are proactive rather than reactive. For organizations that can see what’s coming down the tracks, there may be no better time than now to begin preparing for a value-based future.

 

Next Generation ACO

 


juberg_headshot.pngMr. Juberg is a manager with GE Healthcare Camden Group and focuses on clinical integration, transactions, and strategic and business planning for healthcare organizations. He has extensive experience with the development of ACOs (financial planning and funds flow modeling), managing Medicare Shared Savings Program applications, and implementing clinically integrated networks. He is also experienced in master facility planning, CMMI Innovation Center grants, medical group valuations, and community needs projections. He may be reached at daniel.juberg@ge.com.

 

Topics: ACO, MSSP, Population Health, CMS, Next Generation ACO Model, MSSP ACO, NGACO, Daniel Juberg

Reminder: Upcoming Next Generation ACO and MSSP ACO Webinars

Posted by Matthew Smith on Apr 16, 2015 5:09:57 PM

webinar_Clouds_icon-resized-600As a reminder, The Camden Group's Next Generation ACO webinar will be held tomorrow, April 17 at 12:00 p.m. ET. If you have not registered for this event and wish to do so, please register via the green button contained in the blog post. Registration remains open for next week's MSSP ACO webinar as well. Please click the "Read More" link, below, to access the full blog post.

The implementation of the new Next Generation Accountable Care Organization (“NGACO”) model for Medicare has made it increasingly clear that ACOs will be a significant part of the government’s commitment to tie 30 percent of traditional Medicare payments to quality or value through alternative payment models by the end of 2016, and 50 percent of payments to these models by the end of 2018.

Whether your organization is just beginning to think about taking steps toward accountable care and considering the Medicare Shared Savings Program (“MSSP”); or if your organization has advanced to the point of considering the NGACO model, The Camden Group’s complimentary webinar series will provide you with background information on the programs to help you make an educated decision as to whether to participate, when to participate and which program is right for your organization.

Join us on Friday, April 17 at 12:00 p.m. ET for the first webinar in the series focusing on the NGACO program. We will discuss the specifics of this new model and the skills needed for a successful launch. Topics will include:

  • An overview of the NGACO model and the key differences between other CMS programs
  • Types of prior experience will be important for success in the NGACO
  • The included alternative payment mechanisms, and unique opportunities for network alignment
  • Next steps and logistics to consider before applying

To register for the NGACO webinar, please click the button below:

NGACO Webinar, Webinar, The Camden Group, Next Generation ACO, Accountable Care Organization

Our MSSP program will be held on Thursday, April 23 at 12:00 p.m. ET. Based on our previous application cycle and operational experience, we will discuss the specifics of the MSSP model and important items for consideration in determining if the time is right for your organization to apply. Topics will include:

  • An overview of the MSSP model and the key differences from other CMS programs
  • The changing value-based landscape and where the MSSP model fits
  • Considerations for leaders evaluating the MSSP program opportunity
  • Key elements and logistics to contemplate before applying*

*The Notice of Intent to apply is non-binding and does not commit an organization to applying. 

To register for the MSSP webinar, please click the button below:

MSSP Webinar, Webinar, The Camden Group, Accountable Care Organization

 

 

 

Our expert facilitators for the webinars include:

bosko_backgroundTawnya Bosko | Ms. Bosko is a senior manager with The Camden Group and specializes in designing and implementing clinical integration, high growth medical service operations (“MSO”) and finance, physician hospital organization (“PHO”) and MSO development, managed care strategy, and physician alignment.

 

 

glaserMishka Glaser | Ms. Glaser is a manager with The Camden Group, specializing in clinical integration, accountable care, and many other innovation strategies. She brings over 15 years of experience in various sectors of healthcare including physician practices, insurance, and pharmaceuticals. Ms. Glaser’s in-depth knowledge of value-based care operations provides a context for assisting clients in navigating population health.

 

jubergDaniel Juberg | Mr. Juberg is a senior consultant with The Camden Group and focuses on clinical integration and ACOs (financial planning and funds flow modeling), Medicare Shared Savings Program applications, and strategic planning. He is also experienced in service line assessment and planning, bundled payments, CMS Innovation Center grants, medical staff needs assessments and development plans, as well as bed needs projections.

 

keberWren Keber Mr. Keber is a manager with The Camden Group and specializes in the development, implementation, and operations of clinically integrated networks (“CINs”) and accountable care organizations. He has assisted hospitals and physician organizations nationwide in achieving clinical integration and success in value-based programs. He has particular expertise in the Medicare Shared Savings Program offered by the Centers for Medicare and Medicaid Service and has advised CINs in their preparation for and participation in the program.

Topics: Accountable Care, MSSP, Webinar, Next Generation ACO Model, MSSP ACO, NGACO

Complimentary Webinars: Next Generation ACOs and MSSP ACOs

Posted by Matthew Smith on Apr 9, 2015 3:37:00 PM

webinar_seriesThe implementation of the new Next Generation Accountable Care Organization (“NGACO”) model for Medicare has made it increasingly clear that ACOs will be a significant part of the government’s commitment to tie 30 percent of traditional Medicare payments to quality or value through alternative payment models by the end of 2016, and 50 percent of payments to these models by the end of 2018.

Whether your organization is just beginning to think about taking steps toward accountable care and considering the Medicare Shared Savings Program (“MSSP”); or if your organization has advanced to the point of considering the NGACO model, The Camden Group’s complimentary webinar series will provide you with background information on the programs to help you make an educated decision as to whether to participate, when to participate and which program is right for your organization.

Join us on Friday, April 17 at 12:00 p.m. ET for the first webinar in the series focusing on the NGACO program. We will discuss the specifics of this new model and the skills needed for a successful launch. Topics will include:

  • An overview of the NGACO model and the key differences between other CMS programs
  • Types of prior experience will be important for success in the NGACO
  • The included alternative payment mechanisms, and unique opportunities for network alignment
  • Next steps and logistics to consider before applying

To register for the NGACO webinar, please click the button below:

NGACO Webinar, Webinar, The Camden Group, Next Generation ACO, Accountable Care Organization

Our MSSP program will be held on Thursday, April 23 at 12:00 p.m. ET. Based on our previous application cycle and operational experience, we will discuss the specifics of the MSSP model and important items for consideration in determining if the time is right for your organization to apply. Topics will include:

  • An overview of the MSSP model and the key differences from other CMS programs
  • The changing value-based landscape and where the MSSP model fits
  • Considerations for leaders evaluating the MSSP program opportunity
  • Key elements and logistics to contemplate before applying*

*The Notice of Intent to apply is non-binding and does not commit an organization to applying. 

To register for the MSSP webinar, please click the button below:

MSSP Webinar, Webinar, The Camden Group, Accountable Care Organization

 

 

 

Our expert facilitators for the webinars include:

bosko_backgroundTawnya Bosko | Ms. Bosko is a senior manager with The Camden Group and specializes in designing and implementing clinical integration, high growth medical service operations (“MSO”) and finance, physician hospital organization (“PHO”) and MSO development, managed care strategy, and physician alignment.

 

 

glaserMishka Glaser | Ms. Glaser is a manager with The Camden Group, specializing in clinical integration, accountable care, and many other innovation strategies. She brings over 15 years of experience in various sectors of healthcare including physician practices, insurance, and pharmaceuticals. Ms. Glaser’s in-depth knowledge of value-based care operations provides a context for assisting clients in navigating population health.

 

jubergDaniel Juberg | Mr. Juberg is a senior consultant with The Camden Group and focuses on clinical integration and ACOs (financial planning and funds flow modeling), Medicare Shared Savings Program applications, and strategic planning. He is also experienced in service line assessment and planning, bundled payments, CMS Innovation Center grants, medical staff needs assessments and development plans, as well as bed needs projections.

 

keberWren Keber Mr. Keber is a manager with The Camden Group and specializes in the development, implementation, and operations of clinically integrated networks (“CINs”) and accountable care organizations. He has assisted hospitals and physician organizations nationwide in achieving clinical integration and success in value-based programs. He has particular expertise in the Medicare Shared Savings Program offered by the Centers for Medicare and Medicaid Service and has advised CINs in their preparation for and participation in the program.

Topics: Accountable Care, MSSP, Webinar, Next Generation ACO Model, MSSP ACO, NGACO

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