Modern Healthcare: CMS extends bundled-pay program timeline

The CMS is giving providers more time to opt into a new federal bundle pay initiative after clinicians and hospitals complained they didn't have the claims data necessary to determine if they wanted to participate. "It gives a little bit a breathing room for a provider already looking data and thinking about how to be successful in the program," said Keely Macmillan, General Manager of BPCI Advanced. 

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Archway Health Expands Advisory Team to Counsel Providers Participating in BPCI Advanced

New Value-Based Care Account Managers Reinforce Data-Driven Advisory Support

WATERTOWN, Mass.--(BUSINESS WIRE)--In preparation for the October 1 launch of the new Bundled Payments for Care Improvement (BPCI) Advanced model from the Centers for Medicare & Medicaid Services (CMS), Archway Health has hired three additional team members to deliver one-on-one advisory support to healthcare organizations and providers preparing to launch their bundled payment programs. Archway is a preferred partner to specialists, hospitals, conveners and other healthcare associations and organizations participating in all of CMS’s bundled payment programs, including those who have applied to BPCI Advanced.

Joining Archway are Alexis Bolick and Samantha Tye as senior value-based care account managers, and Tori Hakim as a value-based care account manager. The three new team members will serve as direct liaisons to organizations partnering with Archway in the current BPCI and the upcoming BPCI Advanced models. In their roles, these individuals will provide personalized advisory support to guide providers toward high-value opportunities for improving processes and outcomes, while also reducing costs.

Joining Archway are Alexis Bolick and Samantha Tye as senior value-based care account managers, and Tori Hakim as a value-based care account manager. The three new team members will serve as direct liaisons to organizations partnering with Archway in the current BPCI and the upcoming BPCI Advanced models. In their roles, these individuals will provide personalized advisory support to guide providers toward high-value opportunities for improving processes and outcomes, while also reducing costs.

“The key to success in BPCI Advanced is through data-driven insights, discovered through personal advisory services,” said Dave Terry, CEO and Co-founder Archway. “We are confident that, through their intellect and experience, Alexis, Sam and Tori will help take our providers to the next level. And, I am proud to add them to our growing team of bundled payment experts.”

All three new team members bring strong healthcare provider experience. Previously, Bolick was a project manager at Tufts Health Plan, where she coordinated the cross-functional components of large-scale projects and organized workflow. She also served as a consultant with Public Consulting Group to state-level Health and Human Services Departments on Medicaid guidelines, programs, and financial stewardship. Bolick earned a master’s degree from the Harvard T.H. Chan School of Public Health with a concentration in Health Management and earned a bachelor’s degree in public policy with a Spanish minor from The University of North Carolina at Chapel Hill.

Previously, Tye was a business analyst in the healthcare practice of Public Consulting Group, collaborating with providers on projects ranging from hospital cost reporting to alternative reimbursement methodology development to revenue maximization. Additionally, Tye worked with a healthcare startup tackling addiction treatment to establish policies and procedures pertaining to operations, finance, and patient administration. Tye attended the Harvard T.H. Chan School of Public Health, where she earned a master’s degree. She also earned her bachelor’s degree at Tufts University in both Community Health and Psychology.

Prior to joining Archway, Hakim was a patient account manager with American Renal Associates. Previously, she held positions of case manager and clinical account specialist at Sanofi Genzyme. She has a strong background in Medicare coverage and reimbursement and is a CMS Certified Application Counselor. Hakim earned a bachelor’s degree in Health Management & Policy from The University of New Hampshire.

Archway Health is a growing company, actively adding professionals in bundled payments and value-based care. To find out more about Archway’s current career opportunities, please visit https://www.archwayhealth.com/careers/.

About Archway Health
Archway Health, founded in 2014 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 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.

Managed Healthcare Executive: Four Ways Payers Can Advance Oncology Value-Based Pay

Key to making changes to cancer treatment is provider engagement, says Mah-Jabeen Soobader, PhD, chief analytics officer at Archway Health, which consults with providers, payers, and employers on value-based care programs.

She recommends tapping into physicians’ competitive nature and being transparent about the data associated with their performance when compared to other oncologists in their group or department. “Most times, they self-correct after looking at the data.”

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Cath Lab Digest: Bundles are Here. Where are the Opportunities?

On March 12th, 2018, CMS closed the 60 day enrollment period to apply for their voluntary BPCI-Advanced program. In a recent article by Cath Lab Digest provided by Terumo Business Edge, Archway Health's GM of BPCI-Advanced, Keely Macmillan, and MedAxiom Consulting's Vice President, Anne Beekman, discuss the opportunities in cardiology in BPCI Advanced. They talk about the two new outpatient cardiac procedures added to the program: percutaneous coronary intervention (PCI) and cardiac defibrillators. "If the goal for CMS and BPCI Advanced is to differentiate this new program by its encouragement of cost savings, quality, and coordination of care, the natural question may be, how much separation is there between cost and quality today? The data around this question might surprise you. Archway Health is an experienced BPCI convener; their analysis of Medicare fee-for-service claims reveals an average wage-adjusted cost for an outpatient PCI 90-day bundle of $15,900. If you are thinking that this cost must be located almost entirely in procedure costs, think again. Of the $15,900 spent during the outpatient PCI 90-day bundle, 30%, or $4,800, represents cost that occurred after the anchor PCI procedure." >> READ ON

 

 

Healthcare Finance News: Unsure about Bundled Payments for Care Improvement model?

The Centers for Medicare and Medicaid Services is reporting high interest in the new Bundled Payments for Care Improvement Advanced model that appears to be moving forward despite a request by the American Hospital Association to delay implementation citing a lack of operational detail, especially over target pricing.

CMS has held two information sessions on BPCI Advanced, the last one on Feb. 15. After the last session, CMS said it has received a high volume of inquiries on the model.

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Cardiovascular Business: Q&A: What do providers need to know about BPCI Advanced?

Since CMS announced its new Bundled Payments for Care Improvement (BPCI) Advanced Model on Jan. 9, healthcare providers have been trying to figure out whether the program is right for them.

On one hand, it gives health systems a chance to earn a 5 percent bonus through the Advanced Alternative Payment Model (AAPM) track of the Quality Payment Program (QPP). On the other, if a system doesn't meet benchmarks for high-value care, it will face financial penalties.

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HealthLeader's Media: CMS Woos Providers With More Gains, Less Risk in Bundled Payments

A few days after CMS released the BPCI Advanced voluntary bundled payment model, industry sentiment remained positive. Our General Manager of BPCI Advanced, Keely Macmillan, talked to HealthLeader's Media about the enthusiasm surrounding the program. 

"Providers should be encouraged about the new BPCI Advanced program, as it provides more opportunities for upside revenue. CMS will now provide a limit to how much downside a provider can be responsible for by providing a 20% stop-loss of their total program size," she says. "Full target pricing details are still forthcoming from CMS, but we expect the new pricing model to be more inclusive.

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Healthcare Finance News: Providers pleased at most of what's in new voluntary bundled payment model

A few days after CMS released the BPCI Advanced voluntary bundled payment model, industry sentiment remained positive. Our General Manager of BPCI Advanced, Keely Macmillan, talked to Healthcare Finance News about the enthusiasm surrounding the program. 

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Skilled Nursing News: SNFs’ Place in New Bundled Payment Model Unclear

On January 9, 2018, CMS announced it's new voluntary BPCI Advanced bundled payment program. Yet, participation opportunities for SNF facilities were not clear. Our General Manager of BPCI Advanced, Keely Macmillan, told Skilled Nursing News, “For bundled payments to be successful, you need post-acute care engagement,” Macmillan said, pointing to the success that PAC providers have already seen in existing models. 

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Healthcare Dive: CMS launches new, voluntary bundled payment model

CMS released its new BPCI Advanced voluntary program on January 9, 2018. Our General Manager of BPCI Advanced shared our early thoughts on the new program with Healthcare Dive.  "There are still more details to come from CMS, but with open enrollment starting so soon, it’s now time for providers and organizations to prepare for participation," she said. 

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