By Paul Cummings
David Clain moderating the Cost and Quality Analytics Panel at FLAACOs
Keynote speaker Dr. Anthony Fauci at the 2022 APG Colloquium
HDAI recently participated in both the Florida Association of Accountable Care Organizations (FLAACOs) conference in Orlando, FL and the APG (America’s Physician Groups) Colloquium 2022 – America’s Physician Groups in Washington DC. Here are a few takeaways from the conferences.
- By 2030, total Medicare enrollment is expected to climb to 81 million people. This 27% increase from 2020 will continue to strain healthcare resources and is creating urgency at CMS (Center for Medicare and Medicaid Services) to move more beneficiaries into value-based payment arrangements. CMS is using different levers to boost the formation of new Accountable Care Organizations(ACOs) and encourage existing ACOs to remain in the program:
- offering advanced payment incentives for new participants
- flexing rules to allow ACOs to earn shared savings even when missing minimum savings rate
- allowing participants to remain in upside-only agreements for a longer periods before transitioning to two-sided risk
- updating benchmarking methodology to encourage longer-term participation and address longstanding concerns
- Success in ACO REACH and other value-based models is dependent not only on providing high-quality and well-coordinated care, but also on timely access to analytics and deep understanding of program regulations. Avoiding common pitfalls such as patient attrition, under-coding and uncontrolled post-acute and specialty spending is essential for success in these programs.
- High levels of clinician burnout have led to national staffing shortages. Healthcare organizations have reacted by funding workforce development programs to train and credential more healthcare providers and support staff. There will be more pressure on risk-bearing organizations to do more with less, and to target the most impactable, highest risk patients for success in value-based arrangements.