Accountable Care, ACO, MSSP

Day 2 4th National ACO Summit

By Gregg A. Masters, MPH

Year four for the annual DC gathering of the best and brightest minds in the ACO space, convened yesterday in pre-conference sessions at the Hyatt Regency, DC. Day 2 kicks off with a keynote by Senator Ron Wyden @RonWyden, followed by a power packed tour de force of ACO operatives:

Opening Panel 4th National ACO
Complete agenda and schedule is available here.

Yesterday was a light ‘twitterstream’ but analytics are here and the transcript is here.

ACO, Affordable Care Act, health reform, Triple Aim

The Medicare Shared Savings [ACO] Program Class of 2014: To Submit, or Not to Submit?

By Gregg A. Masters, MPH

Thinking about submitting for participation in the ‘statutory’ Medicare Shared Savings (MSSP) vs. Pioneer, or Advanced payment model ACO programs? While there is certain overlap and confusion, stay tuned for CMS to clarify both in nuance terms and well as key operational indicia. By and large my understanding is this is a provider call for participation in the MSSP.

Medicare Shared Savings Program  Application Process  National Provider Call Tomorrow, April 9th, 2013 CMS is hosting a national provider call to detail the process and timelines for the class of 2014 submissions. So if you are thinking about, or might be leaning in favor of or have made the determination to submit, this is an informational call you’ll want to participate in.

The registration details are here, and the deck is here. This will be followed by ‘Tips on Completing a Successful Application’ on Tuesday, April 23, 2013 from 1:30-3pm ET. See complete provider call summary details here.

Thanks to Alan Gilbert aka @TeamOfCare for posting the announcement via LinkedIn.


Medicare Shared Savings Program & Advance Payment Model Application Process

By Gregg A. Masters, MPH

Per recent CMS Provider Call:

From a CMS ‘National Provider Call’ on July 31, 2012, this is a walk through of the Medicare Shared Savings Program and Advance Payment Model Application Process. The review includes both an overview, and update specific to the two distinct programs. A Q&A session follows the presentations.

CMS accepts comments, here. As well as via the HHS Privacy Policy, here.


Medicaid and HITECH Conference: Fourth Annual

By Gregg A. Masters, MPH

From the CMS. Originally posted here.

To view the live conference video streaming feed, including accessing the agenda and related conference materials and handouts, click here.

Please join the Centers for Medicare & Medicaid Services (CMS) as we host a three-day conference for State Medicaid agencies, and other Federal and State partners.  The conference will focus on the Medicaid EHR Incentive Program and Health Information Technology.

Conference attendees will have an opportunity to:

  • Participate in dynamic workshops with CMS, Federal partners, State Medicaid colleagues, and industry leaders;
  • Share best practices and lessons learned on issues related to implementation, financing, operations, and other areas that will help demonstrate the value and impact of health information technology and health information exchange;
  • Collaborate with agencies such as the Office of the National Coordinator for Health Information Technology (ONC), the Health Resources and Services Administration (HRSA), the Agency for Healthcare Research and Quality (AHRQ), Indian Health Service (IHS), and the Centers for Disease Control and Prevention (CDC).

Dates: April 10-12, 2012

CMS will host a three-day conference beginning on the afternoon of Tuesday, April 10 through the afternoon of Thursday, April 12.

Daily Registration and Session Schedule
Tuesday, April 10, 2012:
Registration 8:00 a.m. – 6:30 p.m.
Sessions 12:00 p.m. – 6:30 p.m.
*New Medicaid HIT Staff Orientation 9:00 a.m – 11:00 a.m.
Wednesday, April 11, 2012:
Registration 7:00 a.m. – 6:00 p.m.
Sessions 8:30 a.m. – 6:00 p.m.
Thursday, April 12, 2012:
Registration 7:00 a.m. – 3:00 p.m.
Sessions 8:30 a.m. – 3:00 p.m
Location:  Hyatt Regency Baltimore on the Inner Harbor300 Light StreetBaltimore, MD 21202


SCOTUS and ACA Day 3 Part Deux: Medicaid Expansion

By Gregg A. Masters, MPH

Here is the audio for ‘Florida vs. The Department of Health and Human Services’.

Here is the transcript.

We are actively searching out the submitted briefs and will post them once found. [Editor’s Note: I invite anyone who may have direct access to post them here in the comments section; it will be much appreciated. I do NOT have Nexis/Lexis access].


SCOTUS Audio and Transcript: National Federation of Independent Business v. Sebelius

By Gregg A. Masters, MPH

Day 3 is no disappointment. The core argument by Florida AG Clement is that if the  individual mandate is ruled unconstitutional, the entire Patient Protection and Affordable Care Act, absent the severability clause, must fall.

Judging from the robust engagement of AG Clement, including an interesting line of questioning from Justice Kagan, (peppered with periodic audience laughter), his argument was enjoined by a somewhat skeptical Court.

P.S. It wasn’t a ‘cakewalk’ for Deputy SG Kneedler either. The Court is engaged on both sides of the arguments presented. A must listen event!

For the audio proceedings of Day 3, click here.

The transcript is accessible here.

[Editor’s Note: Later today, the Court hears the arguments over states’ rights and the expansion of Medicaid under the Act].


ACO reimbursement, bundled payments, clinical quality measures and public profiles will be based on ICD-10 data

By Lynne Thomas Gordon

Healthcare leaders are juggling multiple pressures, including the consistent delivery of high-quality patient care, evaluation and development of accountable care organizations, the careful management of sensitive patient data, achieving meaningful-use criteria, making the most efficient use of the newest technology and stretching revenue to maintain end-to-end coverage of their bottom lines.

With so many priorities, it’s easy to become distracted from managing important changes such as the International Classification of Diseases, 10th Revision, or ICD-10. But there’s an urgent date on our calendars: the HHS’ final implementation date of Oct. 1, 2013, is a hard deadline that will trigger dramatic, though different, consequences for both those who will be prepared for the change and those who won’t. ACO reimbursement, bundled payments, clinical quality measures and public profiles will be based on ICD-10 data.

Given the high stakes, it is imperative that healthcare leaders avoid getting so caught up in the day-to-day that we fail to prepare properly for the many important changes that the ICD-10 conversion will demand from us.

The change to ICD-10 provides the U.S. the chance to discard the technologically outdated, medically inferior ICD-9 coding system and join all other World Health Organization member nations that have been successfully using ICD-10 to manage patient data for more than 15 years. Healthcare leaders will find that the more granular ICD-10 codes will provide opportunities to improve workflows, dive into quality improvement initiatives, demonstrate the severity of conditions being treated and participate with the rest of the developed world in the meaningful exchange of patient data for matters related to public health, scholarly research and the overall advancement of global health information management.

While multiple surveys conducted by AHIMA over the past year-and-a-half show promising signs that healthcare organizations are now making progress in planning for the ICD-10 conversion (85% of respondents recently indicated that they had begun work on ICD-10 planning and implementation), much work still remains if we’re to continue meeting implementation milestones. There is very little time for any industry providers or professional communities involved in data set management to lag behind or experience untimely (cont’d).

Read complete Modern Healthcare Article, click here.

Lynne Thomas Gordon is CEO of the American Health Information Management Association.