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.  

Cath Lab Digest: Bundles are Here. Where are the Opportunities?

On March 12th, 2018, CMS closed the 60 day enrollment period to apply for their voluntary BPCI-Advanced program. In a recent article by Cath Lab Digest provided by Terumo Business Edge, Archway Health's GM of BPCI-Advanced, Keely Macmillan, and MedAxiom Consulting's Vice President, Anne Beekman, discuss the opportunities in cardiology in BPCI Advanced. They talk about the two new outpatient cardiac procedures added to the program: percutaneous coronary intervention (PCI) and cardiac defibrillators. "If the goal for CMS and BPCI Advanced is to differentiate this new program by its encouragement of cost savings, quality, and coordination of care, the natural question may be, how much separation is there between cost and quality today? The data around this question might surprise you. Archway Health is an experienced BPCI convener; their analysis of Medicare fee-for-service claims reveals an average wage-adjusted cost for an outpatient PCI 90-day bundle of $15,900. If you are thinking that this cost must be located almost entirely in procedure costs, think again. Of the $15,900 spent during the outpatient PCI 90-day bundle, 30%, or $4,800, represents cost that occurred after the anchor PCI procedure." >> READ ON

 

 

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
 

Archway Health Introduces Archway Academy to Educate Providers on BPCI Advanced

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.

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.  

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.

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.”

Read the full article here

McKnight's: Skilled nursing facilities see opportunity as CMS finalizes cancellation of bundled pay models

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.

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

Archway Health Launches User Experience Enhancements to Carelink

We are proud to introduce design enhancements of our proprietary patient tracking tool, Archway Carelink, a software platform part of our bundled payment management suite. The updates and enhancements reflect specific client feedback and address elements specifically requested. We are committed to continuously improving our platform to make sure that our clients have the best tools and resources to succeed in bundled payments. The design updates were made in collaboration with a leading user experience firm, UXL.

With this redesign, we developed an interactive, comprehensive dashboard for patient monitoring. It includes a streamlined episode list and an episode record, which tracks patients throughout the care journey.