ACOs in both the public and private sector have continued to grow over the past several years, ushering in more experience and evidence on what is working and ways to continue evolving accountable care models. The Seventh National Accountable Care Organization Summit (www.ACOSummit.com) will provide an unprecedented opportunity to discuss remaining barriers to widespread ACO implementation, strategies to overcome them, and policies to encourage the continued growth and sustainability of the accountable care movement. The Summit brings together leading policymakers, experts, and ACO implementers to provide unique and in-depth insights on ACO implementation and ongoing health care reform. The Summit will cover a variety of topics including innovative contract and payment arrangements, performance measurement, clinical practice transformation, the impact of bundles on accountable care, care for high-risk patients, opportunities for specialty care integration, the development of new pharmaceutical pricing and payment models, maximizing data and technology, and strategies to work with community care providers. The Summit will also be a great opportunity to explore the future of accountable care contracting, practice, and policies, including the impact of the Medicare Access and CHIP Reauthorization Act (MACRA).
WHAT IS AN ACO?
ACOs are groups of physicians, hospitals, and other providers that receive financial rewards for achieving patient-focused quality targets and demonstrating reductions in overall spending growth for their defined patient population. ACOs can be organized in a number of ways, ranging from fully integrated delivery systems to networked models within which physicians in small office practices can work together to improve quality, coordinate care, and reduce costs. ACOs can also feature different payment incentives, ranging from “one-sided” shared savings within a fee-for-service environment to a range of capitation arrangements with quality bonuses. In addition, ACOs are compatible with a range of other payment reforms, such as medical homes and bundled payments; they can help assure that these reforms lead to sustainable quality improvements and cost reductions. In sum, ACOs provide an ideal mechanism to transition from paying for volume and intensity to paying for value.
HOW IS ACO IMPLEMENTATION PROCEEDING ACROSS THE COUNTRY?
As of January 2016, over 400 organizations across the country are participating in the Medicare Shared Savings Program (MSSP), which aims to promote accountability for the care of Medicare FFS beneficiaries, coordinate care for all services provided under Medicare FFS, and encourages investment in infrastructure and redesign care processes. Last Summer the Centers for Medicare and Medicaid Services (CMS) released a final rule that changed a number of aspects of the program, such as providing additional incentives and time for organizations to move to two-sided risk, including into a new Track 3; more flexibility on payment arrangements; and revised administrative processes. CMS is also finalizing a regulation to update the way financial benchmarks are set, including by factoring in regional cost data. In January, over 20 organizations joined the Next Generation ACO Model, which provides greater financial risk and reward, in exchange for even more payment and regulatory flexibility to facilitate better coordination of care. In addition to these changes in Medicare, providers are preparing for implementation of MACRA, which will create additional incentives beginning in 2019 to provide care to Medicare patients through alternative payment models such as ACO and bundled payments.
Beyond Medicare ACO initiatives, interest and participation in accountable care reforms has been growing both in states and in the private sector. More than ten states have developed programs to support the transition toward ACO-like models for either their Medicaid programs or state employees. There are now over 300 private sector ACOs with all of the major private health plans implementing payment reforms similar to the ACO model; like ACOs, these payment reforms include accountability for the full continuum of patients' care, payment contingent upon improving the quality and coordination of care, and responsibility for cost management within a target budget. In tandem with the Medicare Shared Savings Program, the Next Generation ACO Model, the Pioneer ACO Model, and other innovative programs in Medicare, these private sector efforts will be instrumental in moving ACO implementation forward as health care reform progresses.
WHO SHOULD ATTEND
- Executives and Board Members of ACOs, Health Plans, Health Systems, Hospitals and Physician Organizations
- Medical Directors
- Nurses, Nurse Practitioners and Other Allied Health Professionals
- Pharmacists and Pharmacy Benefit Managers
- Representatives of Purchasers, including Private Employers and Public Purchasers
- Consumer Organization Representatives
- Federal and State Government Officials
- Health Care Regulators and Policy Makers
- Health Benefits Consultants
- Health Services Researchers and Academics
- Health Care Attorneys and In-house Counsel
- Chief Financial Officers
- Chief Innovation Officers
- Directors of Accountable Care
- Directors of Quality Management and Improvement
- Directors of Government Programs
- Directors of Medicare Programs
- Directors of Medicaid Programs
- Directors of Network Contracting
- Directors of Provider Relations
- Directors of Finance and Reimbursement
- Pharmaceutical Executives
- Pharmaceutical Consultants