In the News

Mastering Bundled Payments with David Terry, Founder & CEO at Archway Health

"We've got a great team here at Archway, there are about 30 people now. Many of us have been in healthcare for a long time and have been committed to finding a better model, a better mousetrap. I think what's getting us closer is much better access to data, much better information and the ability to fold that into these different types of reimbursement models." 

Hear David Terry discuss his journey and what Archway is doing to advance payment reform here.

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. 

Read more here

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.

Read the full article here

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.

Read the full article here
 

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.

Read the full article here

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. 

Read the full article here

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. 

Read the full article here

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.  

HealthLeaders: CMS Cut to Outpatient Drugs Will Hit Some 340B Hospitals Hard

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." 

Read the full article here

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.

Skilled Nursing News: Skilled Nursing Providers Have Mixed Feelings on Bundled Payments

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.

McKnight's: 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.