Keely Macmillan featured in Healthcare Finance News

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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Keely Macmillan featured in Cardiovascular Business

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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Keely Macmillan Featured in HealthLeader's Media

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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Keely Macmillan Featured in Skilled Nursing News

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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Keely Macmillan Featured in Healthcare Dive

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. 

Read the full article here.  

Letter to the Editor Featured In Modern Healthcare

Last October, CEO and Co-founder of Archway Health, Dave Terry, wrote a letter to the editor of Modern Healthcare regarding an article the organization published about providers' experiences with bundled payments. The article highlighted the value of bundled payments and growing popularity among surgeons. Dave's letter to the editor urges healthcare professionals to not only examine the value of bundled payments, but also to discover how to maximize effectiveness of the programs. 

Read the full article here

Dave Terry on CMMI'S "New Direction" in HFMA

The Healthcare Financial Management Association (HFMA) recently posted an article written by Archway Health's CEO, Dave Terry, titled "CMMI's 'New Direction' Points to the Future of Bundled Payments." The article discusses the future of value based care and what payment models providers will be able to leverage. He explains that, "With CMS steering the healthcare industry in a new, physician-led direction, providers can stay ahead of payment reform with bundled payment programs. The changes happening at CMS should be heartening to physicians as they will be championed as leaders in the continued shift from fee-to-service to value-based care." Read the full article from HFMA here.

Keely Macmillan Featured in Morning Consult

Although CMS recently announced many changes to current mandatory bundled payment models, industry groups believe that the government will continue to shift the U.S. health care system away from fee-for-service care models and push it towards value-based care. Providers expect that the Trump administration will "take a more conservative approach to bundled payments, with a focus on voluntary participation and fewer regulations."  

Morning Consult interviewed Archway Health's GM of BPCI, Keely Macmillan, on her thoughts of the recent CMS announcements. She said CMS “wanted to clear the way for them to test more voluntary initiatives and that allowed them to have more flexibility in testing new innovations,” and “by pulling back those hospital mandatory programs, they can launch other physician-driven alternative payment models that are voluntary and more inclusive of a broader provider audience.”

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Archway Health Featured in McKnight's

Last week, Archway Health CEO, Dave Terry, and GM of BPCI, Keely Macmillan, were featured in an article by McKnight's discussing recent CMS announcements.

On November 30th, 2017 CMS confirmed the cancellation of mandatory bundled payment models for hip fractures and cardiac care, as well as modifications to the Comprehensive Care for Joint Replacement Model. CMS Administrator Seema Verma said, “While CMS continues to believe that bundled payment models offer opportunities to improve quality and care coordination while lowering spending, we believe that focusing on developing different bundled payment models and engaging more providers is the best way to drive health system change while minimizing burden and maintaining access to care.” 

Archway's Keely Macmillan believes that the announcement is “great news for nursing home providers,” and that this, “really clears the way for SNFs to be engaged in these voluntary programs.” 

At Archway Health, we believe that the cancellations of mandatory models pave the way for voluntary success by giving engaged providers the opportunity to innovate around the best way to care for their patients across the full continuum of care.

Read the full article by McKnight's here.

Keely Macmillan Featured in Health Leaders

Archway Health's General Manager of BPCI, Keely Macmillan, was recently featured in an article by Health Leaders discussing the federal government reducing medicare payment for outpatient drugs in CMS' 340B program. She says, "Right now, the hospitals make a big margin on these drugs they're purchasing and can use that money how they want," Macmillan says. "The intent of the program is commendable, to help safety net hospitals that care for our most vulnerable population, treating the uninsured and the most Medicare and Medicaid patients. The biggest failure of the 340B program has been a total lack of transparency and accountability on the dollars that flow through this program." 

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HealthExec Q&A on CMMI's "New Direction"

Last week, Archway Health's CEO, Dave Terry, and GM of BPCI, Keely Macmillan, were interviewed by HealthExec on their predictions of where this 'new direction' will take CMMI. "I do think this new administration, whether they might have a different approach or just a different name, they do genuinely want to get rid of waste in the system and reduce unnecessary federal spending," Macmillan said.  "Regardless of who you are, I think the need to reduce excess spending by Medicare and redirect those funds is universally recognized." CEO Dave Terry correctly predicted that the new leadership would change the participation of the program from mandatory to voluntary, and he believes that this transition paves the way for voluntary success. Terry said, "What we saw with the mandatory models is not very high engagement from the participating hospitals and really watered-down rules to make it palatable. It just really didn’t move the needle on improvements. The voluntary ones, you see tremendous engagement from the physicians and providers, you see them moving the needle quickly and effectively, and that starts to change markets. You don’t need that many participants to wake up the competition and start moving towards improvement. We actually think the voluntary ones will change and shape markets faster than the watered-down mandatory ones."

Read the full Q&A here.

Archway Health in Skilled Nursing News

Archway Health CEO Dave Terry was recently quoted in Skilled Nursing News' article "Skilled Nursing Providers Have Mixed Feelings on Bundled Payments". The article discusses a recent survey conducted by Archway Health that examines how Bundled Payments for Care Improvement (BPCI) both lower the cost of post acute care and enhance care quality. “Of folks who actually participated, [if you asked], have you seen improved quality and reduced costs, I think you’d see both,” Terry told Skilled Nursing News. “This is a pretty broad audience, who might be getting ready to participate.”

Read the full article by Skilled Nursing News here.

Recent Cancellation of Mandatory Payment Models Surprises

Archway Health CEO Dave Terry was recently quoted in McKnight's article titled "CMS surprises-and doesn't- with pay model changes" on the elimination of previously mandatory payment models. “We thought [the models] would probably be switched from mandatory to voluntary,” he said. “But we didn't think they would be eliminated, just because there is demand for these programs on the voluntary side.” Although the complete elimination of the program was a surprise to many, experts predicted a shift from mandatory participation to voluntary. As we previously highlighted in this blog post, our team at Archway believes that this news is promising for the future of voluntary programs.

Read the full article on McKnight's.

Archway Health Bolsters Team Ahead of Expected New Bundled Payments Programs from CMS

Additions of General Manager of BPCI, Director of Operations, Senior Client Manager, and Client Manager Bring a Broad Scope of Healthcare Experience

WATERTOWN, Mass., – September 7, 2017 – With an expected announcement of a new bundled payments program from the Centers for Medicare and Medicaid Services (CMS), Archway Health has hired four new team members to bolster and expand the organization’s capabilities, operations, and client services. Currently, Archway is a leading partner to specialists, hospitals, conveners and other specialty healthcare providers in CMS’s Bundled Payments for Care Improvement (BPCI); it is believed a new program will be announced within the next month.

Keely Macmillan joins as general manager of BPCI, a new position for the company, and will oversee the next generation program. In addition, Archway hired Tim Williams, director of operations; Jacqueline DaSilva, senior client manager; and Jackie Jacobs, client manager.

“We fully expect and are prepared for the next generation of Medicare bundled payment programs, and have added to our team to help providers prepare as well,” said Dave Terry, founder and CEO. “At Archway, we are committed to building the premier bundled payments team, and I am excited to bring on board team members that have the deep experience and expertise in this space to help improve our organization today and better position us for tomorrow.”

Previously, Macmillan was manager of government payment policy at Partners HealthCare, the largest health system in Massachusetts, where she managed public payer financial forecasting and led the government payment policy team in the analysis of performance-based reimbursement models. Among other topics, Macmillan is recognized as an expert in alternative payment models including bundled payments, ACOs, value-based purchasing, and MACRA’s Quality Payment Program. Macmillan earned a master’s degree from the Harvard T.H. Chan School of Public Health and a Bachelor of Science from Yale University.

In addition to Macmillan, Williams, DaSilva, and Jacobs all joined the company in new positions.

Williams is an accomplished strategist in the healthcare technology industry, with nearly 10 years of experience in value-based healthcare. He will join Archway as director of operations, while also serving as product manager for Carelink, Archway’s patient-tracking platform. Previously, Williams drove care coordination efforts at MaineHealth ACO, leading development of a strategic plan for population health management. He also held senior strategy positions at RxAnte and Health Dialog. He earned an MBA from Johnson Graduate School of Management at Cornell University and a Bachelor of Arts in Managerial Economics from Colby College.

DaSilva has a diverse background in healthcare consulting, management and client relations. As senior client manager, she will guide providers in their bundled payment program design, setup and ongoing management. Previously, DaSilva was director of quality improvement at Kindred Hospital, and also was performance improvement manager with Cape Cod Healthcare’s ACO. She earned a Bachelor of Arts from Bryn Mawr College and a Bachelor of Science in Nursing from the Massachusetts General Hospital Institute of Health Care Professional School of Nursing.

Jacobs has a range of healthcare and client management experience in both commercial and nonprofit settings. As client manager, she will assist bundled payment participants in navigating their program. Previously, Jacobs managed patient accounts on a national scale at American Renal Associates, in addition to working with A Little Easier Recovery nonprofit organization for cancer patients. She earned a Bachelor of Science in Public Health from the University of Massachusetts Amherst.

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

 

Media Contact: Olivia Armstrong 781.924.6714 oarmstrong@hencove.com

Voluntary Participation in Bundled Payments Will Continue after Cancellation of Mandatory Programs

In the article "Voluntary participation in bundled payments will continue after CMS cancels mandatory initiatives, experts say," Healthcare Finance interviews experts for their thoughts on the recent news of the proposed rule by CMS to cancel the episode payment models and the cardiac rehabilitation incentive payment model. Experts interviewed by Healthcare Finance, including Archway Health CEO Dave Terry, "believe the switch from mandatory to voluntary bundles is positive for providers and will not affect participation or the movement to value-based care."

Eliminating the mandatory models gives CMS greater flexibility to design and test innovations that will improve quality and care coordination across the inpatient and post-acute-care spectrum, the agency said in the proposed rule.

Read the full article from Healthcare Finance.

Healthcare Experts Comment on New CMS Proposed Rule

As part of their reporting on the new proposed rule released by CMS on Tuesday, McKnight's interviewed healthcare experts to learn their insights into the proposal. In an article titled "CMS proposes cancelling cardiac, orthopedic bundled payment models," Archway CEO Dave Terry tells McKnight's that some changes to the programs had been expected in light of Department of Health and Human Services Secretary Tom Price's support of voluntary bundled payment programs instead than mandatory programs. Dave says:

“We thought [the models] would probably be switched from mandatory to voluntary … but we didn't think it would be eliminated, just because there is demand for these programs on the voluntary side.”

Some experts, including Dave, have said that there is a possibility that CMS may make the models voluntary rather than canceling them entirely:

CMS may also roll it into the upcoming BPCI Advanced initiative, which Terry believes will still “move full speed ahead.”

Read the full article from McKnight's here.