Agenda Fall 2019
September 25 – 27
Marriott Wardman Park, Washington, D.C.

7:30 – 8:15 am

Driving Value by Addressing Malnutrition Across the Care Continuum
Speaker: Michael E. McKenna, M.D.

Dr. Michael McKenna, MD will describe the value of nutrition across different settings of care as a way to improve the health of patients with poor nutrition and reduce healthcare costs. ​Join us as Dr. McKenna ​shares his experiences with the implementation of real-world, comprehensive nutrition care models that are sustainable and scalable across US healthcare systems.

Sponsored by: Abbott 

7:30 – 8:15 am

Speakers: Maria Nikol, Salient Healthcare; Kelly Conroy, Holy Cross Physician Partners

Join Holy Cross Physician Partners and Salient Healthcare as they walk through a case study on how Holy Cross Physician Partners used baseline data to study their post-acute care pathways, implemented key initiatives to drive desired outcomes, and how their ongoing continuous process improvement efforts are assisting their organization to developing high value networks. Ultimately, this study will assist the organization so that when risk comes at full force, they can be reassured that their care pathways will result with the best patient care possible.

Sponsored by: Salient Healthcare

7:30 – 8:15 am

Partnering For Success: How naviHealth & PatientPing Are Improving ACO Outcomes and Care Coordination Efforts
Speakers: Tom Divinnie, naviHealth and Namita Seth Mohta, PatientPing

By joining forces at a large ACO participating in the Medicare Shared Savings Program (MSSP), naviHealth and PatientPing have been able to deliver clear visibility into ACO patient events, engage over 85% of all Skilled Nursing Facility (SNF) admissions, and touch more patients than ever before, significantly impacting savings and readmissions. naviHealth care coordinators in the field are now armed with decision support technology and the real-time data on ACO patients that can provide transparency into where and when patients are receiving care. Join us to learn about the value and impact a combined solution like ours has on strategic objectives critical for ACO success.

8:30 – 10:00 am

Welcome
Clif Gaus, President and CEO, NAACOS

Opening Plenary: Private Payer and ACO Efforts to Transform Health Systems
Will Shrank, Chief Medical Officer, Humana

Panelists: Katherine Schneider, Delaware Valley ACO; Rob Fields, New York Medical Partners ACO; Kim Kauffman, Summit Medical Group – TN; Tom Kloos, Atlantic ACO

10:00 – 10:30 am

Break

10:30 am – 12:00 pm

Understanding the Medicaid ACO Landscape
Chair: Judy Moore, NAACOS Consultant

Panelists: Carrie Arsenault, Eastern Maine Healthcare System; Pam Halvorson, UnityPoint Accountable Care; Kathy Parsons, CentraCare and Central Minnesota ACO, LLC; Patt Richesin, Kootenai Accountable Care, LLC

A number of state Medicaid programs have implemented value-based payment arrangements, including some states that focus their programs around ACOs. While the accountable care programs vary across states, there are some common Medicaid-specific challenges and approaches. This session will include a presentation of the landscape of the types of state Medicaid ACO initiatives and individual ACOs to present their own experiences and describe recent ACO developments in their state’s Medicaid programs. 

10:30 am – 12:00 pm

Caring for Acute Patients in Non Hospital Settings
Chair: Tom Kloos, Atlantic ACO
Panelists: Mark Calderon, Atlantic ACO; Daniel Durand, LifeBridge Health System; Ruth Scott, Integra Community Care Network

This session will explore strategies of care for acute patients through alternatives to hospital admission, utilizing the use of early interventions via an expanded virtual Hospital, enhanced hospital at home and home care services, and leveraging specialist- PCP collaborations in alternative sites of care.

10:30 am – 12:00 pm

Building a Rewarding Culture: Examples of Incentive Plans for Work Roles Beyond Physicians
Chair: Kimberly Kauffman, Summit Medical Group - TN
Panelists: Tracey King, Starling Physicians; Jamie Reedy, Summit Medical Group - NJ; Jennifer Ross, Primary Care Alliance; Rachel Wood, The Advisory Board

It is well acknowledged in value based care that physician engagement is essential for success. It is also recognized that building high performing teams around physicians is key to realizing organizational goals. While the clear next step would seem to be an incentive plan for those teams, few organizations distribute shared savings / bonuses / profit to work roles beyond physicians. Learn from organizations which have successfully implemented this next step to success in value based care.

10:30 am – 12:00 pm

Policy Update
Co-Chairs: Allison Brennan and Jennifer Gasperini, NAACOS

This session will review key regulatory issues for ACOs including Pathways to Success policies that have recently taken effect, proposed Quality Payment Program and Medicare Physician Fee Schedule policies for 2020, and other recent policy developments of which ACOs should be aware.

12:00 – 1:30 pm

Lunch Plenary 

Speaker: Elisabeth Rosenthal, MD
Editor-in-Chief
Kaiser Health News

1:30 – 2:00 pm

2:00 – 3:30 pm

Protecting Your ACO Against Risk: Repayment Requirements
Chair: Kim Busenbark, Wilems Resource Group
Panelists: Jessica Landin, Evolent Care Partners; Toby Shum, Aledade

As ACOs prepare to move into risk many are struggling to understand the CMS requirements around Repayment Mechanisms. This panel session will break down the technical requirements while providing tangible insight into the pros and cons of the available repayment mechanisms, identifying appropriate sources for funding, and how to balance risk within your ACO.

2:00 – 3:30 pm

Transforming Primary Care to Deliver Value
Chair: Rob Fields, New York Care Partners
Panelists: Meena Bansal, Mount Sinai Care; Ruchi Tiwari, Mount Sinai Care

Changing the care model to support population health efforts can be difficult. In this session, the panelists will describe practical interventions to transform outpatient delivery systems to support population health efforts. Among the topics covered will be the implementation of ambulatory clinical pharmacy, use of high medical assistant:provider ratios, and use of texting and other technology all in ways that are financially sustainable. 

2:00 – 3:30 pm

Painting the Full Patient Portrait: Improving Ambulatory Clinical Documentation
Chair: Jen Moore, MaineHealth ACO
Panelist: Sujata Agarwal, St Francis HealthCare; Beth Patak, Bon Secours Mercy Health; Jennifer Tardif, MaineHealth ACO

Objectives:

• Define the essential elements of an effective ambulatory clinical documentation program,
• Describe the benefits to patient, providers, and the ACO,
• Share provider engagement strategies and lessons learned.

2:00 – 3:30 pm

Deciding Which Path Is Best for Your ACO- New Value-Based Models 
Chair: David Pittman, NAACOS
Panelists: Travis Broome, Aledade; Emily Brower, Trinity Health; Pauline Lapin, CMS Innovation Center

This session will discuss a number of new value-based payment models recently introduced by the Innovation Center. Speakers will review details of the new Primary Care First and Direct Contracting models and how these programs overlap with ACOs. The audience will also hear from ACOs currently applying for these programs and discuss opportunities and challenges presented by the models. The audience will hear from ACOs applying to these programs as well as Innovation Center staff, and there will be time for a discussion of the opportunities and challenges presented by the models.

3:30 – 4:00 pm

4:00 – 5:30 pm

Peer to Peer Exchange

Each ACO model has its own set of features, challenges, and strategies for success. Attend a peer exchange exclusively with your ACO peers where you can share your challenges, learn from peers, and hear from experts about the strategies that work for your type of ACO.

No Risk
Minimal Risk
Enhanced Risk
Next Generation
Private Payer

5:30 – 6:30 pm

Actuarial Insights into ACO Composition and Approaches to Maximize Shared Savings
Speakers: Colleen Norris, Jonah Broulette, Sarah Moore, Darin Muse and Raheel Sohail, Milliman

This presentation will focus on the technical approaches ACOs can use to improve performance, especially with respect to ACO composition. In particular we will discuss the following:

• Practical approaches to use claims data to determine what providers or TINs are making the greatest contribution to ACO success.
• Tools and techniques that can be used to promote financial success under the ACO program, particularly with regard to understanding benchmark and risk score adequacy.
• A discussion of how ACO composition impacts low revenue / high revenue status, the implications upon ACO renewal, and options an ACO might consider to be classified as “low revenue.”

The presentation will include a special focus on practical examples, so ACOs can leave with the framework for how to investigate these issues within their own organization.

Sponsored by: Milliman

Building an Effective Behavioral Health Engagement Model Strategies that Work for Commercial, Medicare, and Medicaid Populations
Speaker: Heather Trafton

Patients with behavioral and mental health conditions are more likely to have higher utilization and medical expense, especially when there are co-morbid medical conditions.  Experienced ACO leader Heather Trafton will explain some of the challenges ACOs face, from population identification to patient engagement, and will share effective strategies for building behavioral health engagement models for different types of populations.   Join us for breakfast and learn more about:

• Setting appropriate goals and measures for a chronic and complex behavioral health management program
• Population identification strategies, including the application of predictive analytics, to find escalating patients before their needs become acute
• Approaches, staffing, and trigger opportunities for patient engagement
• Engaging and supporting primary care providers

Plenary

Roadmap for ACO Success
Meridith Seife, Deputy Regional Inspector General for the Office of Evaluation and Inspections at the U.S. Department of Health and Human Services (HHS) 

Discussants: Stephen Nuckolls, Coastal Carolina Quality Care; Richard Feifer, Genesis Healthcare and Sandra Van Trease, BJC ACO

Contracting with Commercial Payers: Practical tips for successful negotiation and collaboration
Chair: Jamie Reedy, Summit Medical Group - NJ
Panelists: Luke Hansen, AMITA Health; Scott Heiser, Blue Cross Blue Shield of North Carolina; Greg Kuzma, Privia Health

This session will focus on practical tips for contracting with commercial payers for alternative payment models, creating successful clinical collaborations with health plans, and applying skills learned from MSSP to commercial ACOs. ACO and health plan executives will share their experiences and advice for translating lessons learned from CMS models to the commercial health plan world.

Leveraging Annual Wellness Visits to Drive ACO Performance
Chair: Richard Feifer, Genesis Healthcare
Panelists: Rob Fields, Mount Sinai; Kevin Shah, Duke Connected Care; John Torontow, Aledade

Annual Wellness Visits (AWVs) represent a significant opportunity to improve ACO performance in a variety of ways. At this session, you will hear from panelists who are maximizing the value of AWVs, through improvements in quality measures, risk adjustment, patient attribution, and advance care planning. Pragmatic approaches to establishing an AWV “program” for ACOs will also be shared, including the use of technology to integrate AWVs into the daily workflow of providers.

Call for Innovations
Chair: Debbie Welle-Powell, Essentia Health
Panelists: Chastity Chace, Physicians HealthCare Collaborative; Christina Lewis, St. Luke's Medicare ACO; Kathy Parsons, CentraCare and Central Minnesota ACO

How do ACOs innovate? Learn about award-winning innovations and how you can apply their success to your ACO. This session will feature the winning submissions to NAACOS Call for ACO Innovations.

More Risk, More Freedom: Making Use of Medicare Payment Waivers
Chair: Maria Alexander, Mount Sinai
Panelists: Melody Danko-Holsomback, Keystone ACO/Geisinger; Stephanie Turner, UNC; Maureen Watchmaker, Beth Israel Deaconess Care Organization

As your ACO prepares to enter downside risk, CMS makes available certain waivers of Medicare payment rules. Wondering whether it's worth the fuss, how to get started, or how to improve your current efforts? Learn from MSSP and Next Gen ACOs with experience implementing programs under the SNF 3-day stay rule and telehealth waivers. The panel will share tips on how to get started, choosing partners, educating providers, and ensuring compliance with CMS requirements.

Mastering Chaos: Achieving High Quality of Care in Multi-TIN/Multi-EHR ACOs
Chair: Bob Rauner, OneHealth Nebraska ACO
Panelists: Don Klitgaard, Heartland Physicians ACO; Tony Reed, Geisinger

This session will discuss the challenges and strategies for achieving high quality of care in ACOs with a less centralized structure. Many studies are showing that independent, primary care-led ACOs are more successful on average compared to vertically integrated health systems, but working within a multi-TIN, multi-EHR ACO poses unique challenges. This panel will describe how they have been able to achieve high quality of care working within a more decentralized and/or “horizontally integrated” structure.

Social Determinants of Health: Moving Beyond Screening to Community Partnerships 
Chair: Megan Reyna, Advocate Aurora Health
Panelists: Terrisca Des Jardins, Physician Organization of Michigan ACO; Caitlin Dunn, Froedtert & the Medical College of Wisconsin; Georgiann Ziegler, Physician Organization of Michigan ACO 

ACOs understand that addressing Social Determinants of Health (SDOH) is necessary for improving health and reducing disparities. This acknowledgement and screening, however, is no longer enough. Local policy changes and partnerships with community organizations to ensure sustainability is needed. This panel will discuss the strategy and implementation of community partnerships and programming to improve whole person care resulting in reduced total cost of care. Further, the panel will address how ACOs are effecting local policy change to impact SDOH and help patients live well.

Lunch Plenary 

Open Mic with CMS
Panelist: John Pilotte

This session includes a town hall format and is an important way for ACOs and HHS/CMS to have an open dialogue about the Medicare ACO program, including discussion on evolving policies and how ACOs fit into the administration’s overall goal of improving Medicare payment and healthcare delivery. This is an excellent opportunity for ACO executives to pose questions and receive answers directly from HHS/CMS leaders and to hear the newest developments straight from the agency.