A4H Executives on the Hill. Members of the A4H Executive Council traveled to DC this week for meetings with Members of Congress, Committee staff, and Administration officials. A4H members emphasized the importance of continuity strategies for CMS Innovation Center models, extending and then restructuring the alternative payment model (APM) bonus, and how accountable care is expanding access to high quality care.

KCC Model Evaluation Shows Quality Improvements. The CMS Innovation Center released the first annual evaluation for the Kidney Care Choices (KCC) model for performance year 2022. KCC is a voluntary model designed to improve care management for Medicare patients with chronic kidney disease stage 4 or 5 and end-stage renal disease (ESRD). The report concludes that in the first year, home dialysis in Kidney Care First and home dialysis training in Comprehensive Kidney Care Contracting (CKCC) increased, and the model increased optimal ESRD starts in CKCC. There was no impact to Medicare spending in the model’s first performance year. These results are promising in terms of quality improvements and encouraging from a cost perspective in the model’s first year. A two-page at-a-glance can be found here.

CMS Innovation Center Updates Policy for MSSP Overlap with GUIDE. The Guiding an Improved Dementia Experience (GUIDE) FAQ now states that respite claims will not be included in Medicare Shared Savings Program (MSSP) expenditures, shared savings, or benchmarking beginning in 2024 for the duration of the GUIDE Model. GUIDE is a voluntary nationwide test that aims to support people with dementia and their unpaid caregivers. CMS pays model participants for respite services (temporary services provided to a beneficiary in their home, at an adult day center, or at a facility that can provide 24-hour care for the purpose of giving unpaid caregivers temporary caregiving breaks). The model also includes a dementia care management payment for care management and coordination, which will be included in 2024 MSSP expenditures and benchmark calculations.

PTAC Meeting on Advancing Total Cost of Care Models. During the Physician-Focused Payment Model Technical Advisory Committee (PTAC) meeting, stakeholders and representatives from the CMS Innovation Center discussed pathways toward maximizing participation in Population-Based Total Cost of Care Models. Looking toward CMS’ 2030 goals for accountable care adoption, panelists highlighted remaining challenges providers face when transitioning to accountable care models and other metrics of success CMS could consider as they pursue accountable care goals. The PTAC agenda and discussion slides can be found here.

A4H Summits Comments on the Physician Fee Schedule. A4H submitted a comment letter to Chiquita Brooks-LaSure, CMS Administrator, regarding the 2024 Medicare Physician Fee Schedule proposals. In the letter, we advocate for policies that will expand and encourage adoption of accountable care, including additional risk tracks for Medicare Shared Savings Program participants, pre-paid shared savings, and disentangling APM performance requirements from MIPS requirements. You can view our summary and letter here.

Double Click on Accountable Care Recap. On September 10, A4H brought together policy professionals to hear presentations on approaches to and perspectives on accountable care for complex populations. During the event, Pauline Lapin from the CMS Innovation Center provided an overview of the CMMI model portfolio models for complex patients. William Robinson with HarmonyCares, Dr. Thomas Lally with Bloom Healthcare and Gary Bacher with CINQCARE, discussed the unique needs of complex patient populations and how the High Needs track of ACO REACH is helping to advance care for the frailest patients. Richard Fuller with Solventum discussed their work to achieve better outcomes and measurement for maternal health. Christopher Kelly, Legislative Assistant to Sen. Marsha Blackburn (R-TN), shared insights on what’s ahead in Congress, including the outlook for the future of Medicare physician pay. Our next Double Click will take place in Washington, DC on December 12. Register here.

Upcoming Virtual Session on Women’s Health. Join Accountable for Health, the National Partnership for Women & Families, and United States of Care for a virtual session as leading experts in healthcare, policy, and patient advocacy explore how accountable care models can enhance the quality, accessibility, and affordability of women’s health services. Register here.

Save the Date for Health Care Value Week. The fourth annual Health Care Value Week will take place February 24-28. A4H will host an in-person event in Washington, DC on February 25. Register here for the in-person event.