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.
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.
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.
A new brief in Healthcare Dive covers news of a proposed rule released by CMS that reduces areas that are required to participate in the mandatory joint bundled payment program and cancels the cardiac bundled payment model. Healthcare Dive concludes the article by quoting Archway CEO Dave Terry's statement that bundled payment models are likely to endure.
Bundled payments are positive for providers and aligns their interests with those of payers and patients, he said.
“In this scenario, acute care will ultimately constitute a smaller component than currently, so hospital payments could well shrink," he said. "However, if hospitals take the appropriate action they can sustain and even grow their bottom lines by more coordinated and prudent use of resources.”
Read the full brief from Healthcare Dive here.
Meet Dave Terry in this new feature by Boston Voyager, part of their Inspiring Stories series. In the article, Dave talks about what led him to found Archway Health. He says:
Over the years I’ve worked in all of the reimbursement models—fee-for-service, population health, global budgets, ACOs—and what I love about the bundled payment model is that it’s the only model that empowers the best experts—specialist physicians—to focus on patients who are sick, and help them get better and get back home.
And over the last few years we’ve seen that this is a better way to deliver healthcare. It's having a big impact on improving outcomes and the patient experience, significantly reducing costs, while also helping the providers we’re working with earn new revenue.
Our goal at Archway is to work with specialty providers, employers, and health plans who also believe this is a better way, and our objective is to help those folks improve care and reduce costs as they build and implement these initiatives.
Read the full article on Boston Voyager here: http://bostonvoyager.com/interview/meet-archway-health-watertown/
Dave Terry, founder and CEO of Archway Health, is quoted several times throughout a new feature published today on Healthcare Dive. The article by Les Masterson is titled "Despite federal delays, bundled payments will be entrenched in US healthcare." Dave tells Healthcare Dive that CMS has shown that they remain committed to bundled payments. This message has been consistent both pre-election and post-election.
Dave also says that though the changes involved in implementing a bundled payment program may feel overwhelming, bundled payment programs ultimately lead to more autonomy and funding to manage patient populations.
"In this scenario, acute care will ultimately constitute a smaller component than currently, so hospital payments could well shrink. However, if hospitals take the appropriate action they can sustain and even grow their bottom lines by more coordinated and prudent use of resources."
The article also mentions the BPCI Advanced program:
There is another bundled payment announcement expected this summer — the next iteration of the BPCI program. No matter when CMS announces its next bundled payment program, Terry said CMS will continue bundled payments — regardless of the delays and the HHS secretary's opposition to mandatory programs.
“There will likely be more delays, but everything we’ve heard and everyone expects in the industry is that it’s coming,” said Terry.
Read the full article here.
In an article in Healthcare Finance titled "Expert: Trump administration 'buying time' by delaying bundled payment programs," Healthcare Finance associate editor Jeff Lagasse talks to Archway Health CEO Dave Terry about what the recent delays announced by CMS mean for bundled payment programs. "It appears to me that they're just kind of buying time," Dave says. "Obviously there's a lot going on right now with CMS, with the healthcare reform bill and the new head of CMS being appointed within the past couple of weeks. I think they're giving themselves some more time."
Modern Healthcare recently published an article titled "CMS delays expansion of bundled payment programs." In the article, writer Elizabeth Whitman reports on the interim final rule published by CMS on the delay. The rule states: "This additional three-month delay is necessary to allow time for additional review, to ensure that the agency has adequate time to undertake notice and comment rulemaking to modify the policy if modifications are warranted, and to ensure that in such a case participants have a clear understanding of the governing rules and are not required to take needless compliance steps."
Archway Health Co-Founder and CEO Dave Terry is quoted in a new article by Susan Morse in Healthcare Finance News. In the article, titled, "As payers see success in bundled payments, critics say model needs fine-tuning,” Dave talks about the interest that commercial payers have shown in bundled payments. "I'm getting a lot more inquiries from commercial plans," he says. "We think we're going to see considerable growth in the bundled payment model."
Archway Health Founder & CEO Dave Terry is quoted in an article titled "Industry Nervously Watching for 2018 Voluntary CMS Bundles” that was recently published on the Healthcare Financial Management Association (HFMA) blog. The article by Rich Daly discusses CMS leadership challenges, the payment models that analysts expect may be launched in 2018, and the interest in bundled payment models shown by private payers. “The fact that CMS is showing results and continues to move it forward is indicating to the market that it is real,” Dave said. “They wouldn’t push it forward if they weren’t seeing some success.”
Read the full article here: http://www.hfma.org/Content.aspx?id=53123
Got a question about bundled payments? Ask us now.
The Oncology Care Model (OCM), a voluntary CMS bundled payment program, has seen strong interest among providers; more than double the number of expected participants have joined. Archway Health, a firm specializing in implementing and managing bundled payment programs across all care settings, today announced that 10 oncology providers have engaged the firm to manage participation in the OCM model since the start of the program in July 2016; Archway gained an additional eight clients within oncology prior to the CMS program launch.
A response from Archway Health Founder and CEO Dave Terry was recently published in the Thought Leader's Corner in the Accountable Care News newsletter. In this section, various healthcare industry experts were asked to answer the following question: "What are the top pitfalls in commercial ACO shared-risk arrangements?" Here is Dave's response:
Commercial ACOs face three significant challenges: multiple business models, new investments and cross-organizational buy-in.
The first issue is trying to operate in two opposing reimbursement systems. Almost every provider organization in the country generates most of its revenue through a fee-for-service model, with incentives that drive more utilization. Yet in the ACO model, incentives are the opposite: They drive value through reducing utilization and partnering with efficient, lower-priced providers.
It is hard for any organization to operate within opposing business models, particularly so for healthcare professionals who often feel morally obligated to treat every patient the same regardless of how their bill gets paid. In order to fully embrace an ACO model, providers need to have 40% to 50% of their revenue derived through risk models with an expectation that they will move toward more than 75% in the next few years.
A second issue is investing in the tools and infrastructure required to succeed within an ACO model. These include claims data analytics, care management teams, patient tracking tools, reinsurance products and sophisticated management teams.
A third issue is gaining buy-in from primary care and specialist physicians within a network. Succeeding within an ACO requires doctors to change the way they deliver care. These changes include physician staffing ratios, new referral partnerships, changes in clinical protocols, increased use of nurse practitioners and physician assistants, better patient communication, telehealth and new ways to use data.
Got a question about bundled payments? Ask us now.
Archway Health CEO and Founder Dave Terry recently spoke to Health Exec on the state of bundled payments in 2017. His responses were published in a Q&A, where Dave explains to Health Exec writer John Gregory "how the policies of President-elect Donald Trump and his pick to run HHS, U.S. Rep. Tom Price, MD, R-Georgia, could benefit value-based care initiatives and bundled payments in both Medicare and commercial insurance." Read the full article here.
Archway Health Founder and CEO Dave Terry shares key pieces of advice for payers looking to implement bundled payments in the recent HealthPayerIntelligence article "Commercial Payers Behind CMS in Bundled Payment Models." “There are couple of things [payers can do]. First, just get started,” he says. “It can be complicated and there can be a lot of hurdles that slow or stop folks from doing these things. What we‘ve seen from payers and providers who are committed to doing this is that they can get through those hurdles. So just getting started and committed to getting a few bundles out in the market is one piece of advice. The second piece would be to start with the data.”
Read the full article here: http://healthpayerintelligence.com/news/commercial-payers-behind-cms-in-bundled-payment-models
A guest post by Archway Health CEO Dave Terry on "Maximizing value for patients through bundled payments" was recently published online in Becker's Hospital CFO. In the post, Dave states the case for bundled payments, arguing that in a traditional fee-for-service model, it can be difficult for patients to determine value in healthcare. In bundled payment models however, determining value in healthcare doesn't have to be a leap of faith for patients. "Because organizations enter into payments arrangements that include both financial and performance accountability, patients can benefit from price transparency, reduced costs of care, and improved outcomes."
Ultimately, "bundled payments provide value that every patient can understand," Dave says.
Read the full article here: http://www.beckershospitalreview.com/finance/maximizing-value-for-patients-though-bundled-payments.html
With the ever-expanding stable of payment reform initiatives, providers are seeking help. Founder and CEO Dave Terry shares his perspective in the Modern Healthcare article "Measuring healthcare performance is their business, and business is good." This media coverage for Archway Health appeared in Modern Healthcare over the weekend and was shared in the publication's highly-read daily newsletter this morning.
From the article: "'This is all we do. This is all we think about,' said Dave Terry, the founder of Archway, a company that works with providers to implement and manage bundled payment initiatives." Archway Health's exclusive focus on bundled payment programs is one of the things that sets Archway apart from other companies. Members of Archway's team of national experts on bundled payment have been involved with these programs since 2011.
Read the full article on Modern Healthcare here.
Archway CEO Dave Terry recently co-authored in the American Academy of Orthopaedic Surgeons AAOS Now blog. Titled “Bundled Payment Models Facilitate Specialist Independence”, the article describes how physician-led bundled payment programs can help specialists exercise greater control of reimbursement and their relationships with other providers in the care continuum such as hospitals, post-acute providers, and other physician specialties.