BPCI Advanced

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.”

Read the full article here.  

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. 

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.

Morning Consult: Providers See CMS Continuing Value-Based Care Push Despite Project Rollbacks

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 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