OCM

Reflecting on ACCC: Commercial Bundle Contracting for Cancer Care

Archway’s chief analytics officer, Mah-J Soobader, PhD,  recently presented at the Association of Community Cancer Centers (ACCC) 44th Annual Meeting and Cancer Center Business Summit in Washington D.C. Each year, the event brings together hundreds of cancer care professionals and thought leaders to explore innovative approaches for navigating the biggest challenges and opportunities in oncology.

As rising healthcare costs have caused industry-wide concern, an opportunity that has been brought to the forefront is developing better ways to pay for cancer care. Dr. Soobader spoke on a policy panel at ACCC, “Preparing for Commercial Bundles in Oncology.” The panel offered insights on successful strategies to simultaneously reduce the cost and improve the quality of cancer care.

Dr. Soobader provided a window into Archway’s process in collaborating with organizations to build successful commercial bundled payment programs. The major takeaway from Dr. Soobader’s presentation is that a clinically-informed, data-driven episode is the key to building an accurate, fair and profitable bundled payment program. Archway helps healthcare organizations gather their performance data and data of peers to determine where the opportunities lie for more efficient care. In finding and testing areas for improvement, providers are then able to negotiate their prices with payors. 

For providers interested in building commercial bundle programs, Dr. Soobader advised, “The pathway to commercial is experimenting in Medicare programs, and experimenting successfully.” In other words, Archway recommends providers participate in either the Oncology Care Model (OCM) or Bundled Payments for Care Improvement (BPCI) Advanced Initiative to determine what works with some guidance from CMS before striking out on their own. Based on experience, Dr. Soobader recommends this approach as a way for organizations to identify key strategies required to be successful in bundled payment programs.

Whether you start with Medicare bundles or are developing your own commercial programs, data-driven insights will be the key to healthcare improvement and financial success in bundled payments. Talk to us about receiving and analyzing your own data to analyze your opportunity in bundles.

Asking the Right Questions to Achieve Success with OCM

At the recent Association of Community Cancer Centers (ACCC) National Oncology Conference in Nashville and the Community Oncology Alliance (COA) Payer Exchange Summit in Virginia, participants in the Centers for Medicare and Medicaid Services (CMS) Oncology Care Model (OCM) discussed the challenges of implementing such a program. Changes have significantly impacted practices’ organizational culture and staffing, among other areas. Since CMS announced the launch of OCM in 2015, oncology care practices have been working to implement and manage bundled payments to learn how to be more efficient and effective providers. While there has been significant learning along the way, some providers have just started discovering their performance. While challenges still remain, we feel that this voluntary OCM bundled payment program is a step in the right direction.

At Archway, we have identified key questions that we recommend all OCM participants consider to determine what is needed to transform their organization:

-       How is my organization currently doing? What are my organization’s performance goals compared to our target expenditures?

-       What are the key drivers of my organization’s performance? How does my organization compare to other practices?

-       What can we change? What are the key drivers of savings and controlling costs? Where is there room for improvement?

Asking these questions is challenging. And some oncology care specialists will see this as a wakeup call as they realize they have limited data and analytics to provide answers. However, practices that operate without knowledge of their results are working blindly. And, the real answers to these questions will lead you to better care and increased savings.

By participating in the OCM bundled payment program, practices can realize opportunities for reducing cost of care and improving care delivery. Claims data is only valuable once it is transformed into actionable insights. To help OCM practices meaningfully analyze this data and manage a successful program, Archway has developed a proprietary online Oncology Care Analytics Suite™ platform. We help organizations tap into deep analytics to better understand performance results based on quarterly costs and trends, spending and claims details and more. Our SaaS-based tool is designed to evaluate and analyze the raw quarterly data delivered by CMS to help oncologists discover how their practice is performing on a clinical and financial level.

Oncology care practices that are participating in OCM are already on their way to achieving the significant impact of understanding the results of value-based payment initiatives. What is your practice waiting for?

Contact us for more information about how we can help your organization answer the three key questions above.

Specialist Engagement is the Key to Bundled Payment Success

In the last 6 years or so, bundled payment activity has picked up tremendously with the Centers for Medicare & Medicaid Services (CMS) both mandating and offering several programs aimed to help providers achieve efficiencies in care. We're encouraged that in a recent article, Modern Healthcare picked up on the success that providers are experiencing within the CMS’s Comprehensive Care for Joint Replacement, or CJR, and Bundled Payments for Care Improvement, or BPCI, programs. While the success highlighted in the article focused on orthopedics and procedural care, both Medicare data and our experience demonstrate that this success has also included significant improvements in quality and cost in chronic conditions like CHF and COPD, even in cancer care with Medicare's Oncology Care Model, or OCM, program.

The key to success has not been what is bundled, but rather who is bundling. A deep look into the data reveals that programs in which specialists are deeply involved have had the most success in both improving care, cutting costs and achieve efficiencies.

Having worked with BPCI, CJR, and OCM participants since the inception of these programs, we have learned that there are four keys to unlocking this level of success with bundled payments programs. And, these work within almost any high-cost, complex acute or chronic condition:

  1. Put the specialists in charge of the process.

Medicare data of BPCI bundles reveal that specialists are well-positioned for leadership and of bundled payment initiatives. In programs with strong specialist leadership and alignment, we have seen costs reduced by more than 14%, where as hospital-driven bundles without specialist engagement saw savings of just 4%.  In addition to lowering costs, specialist led programs achieved greater decreases in length of stay and declines in skilled nursing facility utilization.

  1. Engage high-volume specialists in critical clinical areas, like orthopedics, cardiology, pulmonology, and oncology.

Orthopedic specialists have gotten a lot of attention in bundled payments with the CJR program. But, with potential cuts to the CJR program, the success of voluntary models can fill the void in a more participatory, rather than mandated way. Additionally, other high-volume specialists should be a major focus, and not avoided.  Complex patients who have historically used lots of resources are also generally have significant variability in costs and outcomes, these patient populations present the best opportunities for improving the process and achieving better results.

  1. Give the specialists the full data sets.

A major factor in any bundled payment success is data. Specialists have to be able to see not only their own, but also data from the full continuum and their peers, to gain a full understanding of where the costs go and what happens to the patients over the course of a complete episode of care. This helps specialists identify the path to improvement for the patients they care for.

  1. Encourage specialists to innovate around the best way to care for their patients across the full continuum of care.

Once specialists are participating in bundled payment contracts and examining the data, in our experience, they begin to innovate all kinds of new and improved ways to care for their patients.

When all four of these elements are at play, we see tremendous improvements in the process, outcomes, the patient experience, and costs start to come down dramatically.

While some were disappointed that the CMS recently scaled back the mandatory programs, the agency has also repeatedly indicated that it will be implementing the next generation of the voluntary BPCI program soon.

Given this continuation and the physician-focused language in the latest RFI concerning CMMI’s “new direction,” we expect the new program to provide even more of an opportunity for specialists—even high-performing ones—to participate in and benefit from value-based payment reform. With the success of the original BPCI programs, CJR and OCM, we expect to see significant demand among specialty physicians and their hospital partners  in the upcoming program.

Archway Health Joins Health Care Transformation Task Force

Alliance of Private Sector Leaders Spearheading Adoption of Value-Based Payment Models

WASHINGTON (May 31, 2017) – The Health Care Transformation Task Force, a consortium of leading health care payers, providers, purchasers and patient organizations working to accelerate the pace of U.S. health care delivery system transformation, announced today that Archway Health, a full-service, tech-enabled bundled payment company, has joined its membership.

As part of the Health Care Transformation Task Force, Archway Health supports the goal of moving 75 percent of business into value-based arrangements that focus on providing person-centered care that is high quality and lower cost through innovative delivery models.

With more than 40 organizations representing patients, payers, providers and purchasers, the Task Force aims to align private and public sector efforts to transform the U.S. health care system. By developing and disseminating strategy, operational and policy recommendations, it seeks to spark rapid, measurable change across the health care landscape.

“At Archway, we believe the transformation to value-based models, and specifically bundled payments, will lead to better patient outcomes, higher-quality care and reduced costs,” said Dave Terry, Co-Founder and CEO of Archway Health. “We’re pleased to join the Task Force to support organizations in entering value-based agreements and contribute to a broader effort to move the industry toward patient-centered care.”

Archway helps providers through each step of the process to implement and manage bundled payments with opportunity analysis, practice transformation and compliance. Archway supports CMS Bundled Payment for Care Improvement (BPCI), Comprehensive Care for Joint Replacement (CJR), Oncology Care Management (OCM) and Episode Payment Model (EPM) programs, as well as with commercial payers who are pursuing bundled payment initiatives.

“Archway Health is a welcome addition to our robust alliance, as we boldly seek to deliver the Triple Aim of better health, better care and lower costs,” said Jeff Micklos, executive director of the Task Force. “Their expertise and support is critical to the knowledge sharing our members need to continue down the path to transformation.”

About Health Care Transformation Task Force

The Health Care Transformation Task Force is an industry consortium that brings together patients, payers, providers and purchasers to align private and public sector efforts to clear the way for a sweeping transformation of the U.S. health care system. Our members are committed to rapid, measurable change, both for ourselves and our country. Our members aspire to have 75 percent of their respective business operating under value-based payment arrangements by 2020. To learn more, visit www.hcttf.org.  

About Archway Health Archway Health, founded in 2011 and built on a deep foundation of healthcare payment reform expertise, works with providers to design and execute care and risk management programs that drive success in bundled payment programs. Archway is currently working with leading healthcare providers participating in the CMS BPCI, CJR, and OCM programs, as well as with commercial payers operating bundled payment initiatives. To support these programs, Archway works with providers to analyze their opportunities and risks and to deploy its comprehensive platform of analytics, patient tracking tools, and advisory services to ensure their success in bundled payments. For more information, please visit www.archwayhealth.com.

Media Contacts:

Christian Hertenstein 202.683.3194 Christian.hertenstein@mslgroup.com

Flannery Nangle 315.406.5495 FNangle@hencove.com

Archway Health Partners with athenahealth’s ‘More Disruption Please’ Program to Help Providers Succeed in Bundled Payments

Watertown, MA, April 5, 2017 – Archway Health, a full service tech-enabled bundled payment company, today announced a partnership with athenahealth, Inc. through athenahealth’s ‘More Disruption Please’ (MDP) program, making Archway Carelink and Archway Analytics part of the athenahealth® Marketplace. This newly integrated application offers athenahealth’s growing network of nearly 88,000 healthcare providers access to Archway Health's comprehensive platform of analytics, patient tracking tools, and advisory services. "Since our company’s inception, athenahealth has been a strong advocate of our approach to bundled payments as evidenced by our membership in the MDP Accelerator," said Dave Terry, Archway Health Co-Founder and CEO. "We’re pleased to continue this partnership and proud to bring our solution to athenahealth’s national network of healthcare providers as they adopt new payment models designed to improve care and reduce costs."

Archway helps providers through each step of the process to implement and manage bundled payments with opportunity analysis, practice transformation and compliance. Archway supports CMS Bundled Payment for Care Improvement (BPCI), Comprehensive Care for Joint Replacement (CJR), Oncology Care Management (OCM) and Episode Payment Model (EPM) programs, as well as with commercial payers who are pursuing bundled payment initiatives.

athenahealth is a network-enabled services company with a vision to build a national health information backbone to help make healthcare work as it should. As an MDP partner, Archway Health joins a network of like-minded healthcare professionals who are looking to disrupt established approaches in healthcare that simply aren’t working, aren’t good enough, or aren’t advancing the industry and help providers thrive in the face of industry change.

To learn more about Archway Health’s new integrated application, please visit Archway Health’s product listing page on the Marketplace: http://www.athenahealth.com/healthcare-technology-partners/archway-health.

About Archway Health Archway Health, founded in 2011 and built on a deep foundation of healthcare payment reform expertise, works with providers to design and execute care and risk management programs that drive success in bundled payment programs. Archway is currently working with leading healthcare providers participating in the CMS BPCI, CJR, and OCM programs, as well as with commercial payers operating bundled payment initiatives. To support these programs, Archway works with providers to analyze their opportunities and risks and to deploy its comprehensive platform of analytics, patient tracking tools, and advisory services to ensure their success in bundled payments. For more information, please visit www.archwayhealth.com.

Media Contact: Flannery Nangle 315-406-5495 fnangle@hencove.com