The Centers for Medicare & Medicaid Services (CMS) recently announced the next generation of the Bundled Payments Care Improvement (BPCI) voluntary payment model, BPCI Advanced. The release of the updated program details officially opened a two-month enrollment window, set to close on March 12. To guide providers in this critical phase, Archway Health, a full-service tech-enabled bundled payment company, today unveiled Archway Academy, an online educational platform designed to help providers succeed in BPCI Advanced.
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.
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.”
Read the full article here
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.
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 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.
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.
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.
Archway Health recently presented at a CV Transforum pre-conference session titled "EPM (Bundled Payments) Boot Camp." Also speaking at the session were Anne Beekman, RN, Vice President, MedAxiom Consulting; Ginger Biesbrock, PA-C, MPH, MPAS, AACC, Vice President, MedAxiom Consulting; Tim Kennedy, Shareholder, Hall, Render, Killian, Heath & Lyman, P.C; and Joel Sauer, Vice President, MedAxiom Consulting.
The CV Transforum took place Tuesday, April 18th through Thursday, April 20th at the Ritz-Carlton, Amelia Island, Florida.
From the CV Transforum agenda:
On December 20, 2016, CMS published the final rule, Advancing Care through Episode Payment Models and Cardiac Rehabilitation Incentive Model. CMS’ stated goals of this rule is to improve quality of care in the applicable episodes, while reducing episode spending through financial accountability.
This intensive, small group boot camp session will allow for depth of discussion and very detailed information sharing on everything you need to know about the final rule. We will provide expert clinical, financial and legal education so you can learn how to benefit from it whether in a chosen MSA or not. This essential boot camp will hit all of the important components of this new rule and the implications to AMI and CABG episodes. Our expert policy, legal and consulting panel will bring valuable insights around the complexities of the rule and discuss how to leverage it while improving the quality of care you provide.
Topics to be covered include:
- Final Rule Summary
- Review of the MedAxiom EPM Data
- Clinical Needs Inside Bundles (pathways, standardization)
- Infrastructure & Alignment Requirements (governance, leadership, physician comp)
- Importance of Coding & Documentation
- Legal Update (acceptable gain sharing arrangements)
Whether you are in a chosen MSA or not, and regardless of what the new administration does, EPMs and value-based medicine is the inevitable future of health care. Stay ahead of the curve and be prepared for the future by participating in this essential bundled payment educational event.
Learn more about the Spring '17 CV Transforum: http://cvtransforum.com/
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 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
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Writer Vera Gruessner included two quotes from an interview with Dave Terry in an article recently published at HealthPayerIntelligence.com. The article, titled “3 Ways Bundled Payment Models Brought Hospital Cost Savings,” looks at case studies that show how these savings were achieved. Dave is quoted as an expert on bundled payment and explains how CMS has handled some of the initial challenges that were part of launching the BPCI program. Read the full article here.
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 is quoted in a new article published in HealthPayerIntelligence.com. In the article by Vera Gruessner, titled "Why Healthcare Bundled Payment Models May Expand in 2017," Dave discusses CMS bundled payment models, prospective versus retrospective reconciliation, MACRA, and the future of bundled payments. For commercial payers looking to get started in bundled payments, he also offers this advice: “Start soon. It’s never too early to start.” Read the full article here: http://healthpayerintelligence.com/news/why-healthcare-bundled-payment-models-may-expand-in-2017