Recent News Releases
CHPA and NACHC comments to CMS on Proposed Pathways to Success MSSP rule changes
In an article released by the National Association of Community Health Centers (NACHC), Abigail Painchaud states, “the Centers for Medicare and Medicaid Services (CMS) has released a proposed rule that would transform their Medicare Shared Savings Program (MSSP), pushing accountable care organizations (ACOs) to take on increasing levels of financial risk. CMS’s proposal, which it is calling ‘Pathways to Success,’ would consolidate and streamline the ACO track options; require that participating ACOs take on two-sided, or both upside and downside risk at some point in their agreement; and promote increased provider flexibility on things like telehealth and patient incentives.” Read the article here.
Comments were submitted to CMS by an October 16, 2018 deadline from various organizations. Below are the comments submitted by NACHC, CHPA, and the National Association of Accountable Care Organizations (NAACOs):
Click here to learn more about the CMS proposed rule.
New Participants Join Several CMS Alternative Payment Models
Numbers demonstrate provider commitment to a health care system with better care, healthier people, and smarter spending
JAN 24, 2017
Denver, Colo.− The Community Health Provider Alliance (CHPA), with 11 Colorado Community Health Center members, was selected as one of 99 new Shared Savings Program ACOs, providing Medicare beneficiaries with access to high-quality, coordinated care across the United States, the Centers for Medicare & Medicaid Services has announced. Beginning January 1, 2017, a total of 480 Shared Savings Program ACOs are serving over 9 million assigned beneficiaries.
The Centers for Medicare & Medicaid Services (CMS) announced over 359,000 clinicians are confirmed to participate in four of CMS’s Alternative Payment Models (APMs) in 2017. Clinicians who participate in APMs are paid for the quality of care they give to their patients. APMs are an important part of the Administration’s effort to build a system that delivers better care and one in which clinicians work together to have a full understanding of patients’ needs. APMs also strive to ensure that patients are in the center of their care, and that Medicare pays for what works and spends taxpayer money more wisely, resulting in a healthier country.
“By listening to physicians and engaging them as partners, CMS has been able to develop innovative payment reforms that bring physicians back to the core practice of medicine – caring for the patient,” said Acting Administrator, Andy Slavitt. “By reducing regulatory burden and paying for quality, CMS is offering solutions that improve the quality of services our beneficiaries receive and reduce costs, to help ensure the Medicare program is sustainable for generations to come.”
The Medicare Shared Savings Program (Shared Savings Program), Next Generation Accountable Care Organization (ACO) Model, Comprehensive End-Stage Renal Disease (ESRD) Care Model (CEC) and Comprehensive Primary Care Plus (CPC+) Model all apply the concept of paying for quality and effectiveness of care given to patients in different health care settings. Today, CMS is announcing the participants in each of these models for the 2017 calendar year.
With today’s announcement, participants in the four APMs are improving care delivery in 50 states, the District of Columbia, and Puerto Rico. In 2017, there are:
- Over 359,000 clinicians participating in APMs
- More than 12.3 million Medicare and/or Medicaid beneficiaries served
- 572 ACOs across the Shared Savings Program, Next Generation ACO Model and CEC Model
- 131 ACOs in a risk-bearing track, including in the Shared Savings Program, Next Generation ACO Model and CEC Model
- 2,893 primary care practices participating in CPC+
“These models demonstrate CMS’s commitment to partner with providers to improve care for patients,” said Dr. Patrick Conway, Acting Principal Deputy Administrator and Director of the CMS Innovation Center. “My mother and over 12 million other Medicare beneficiaries are now cared for by doctors and other clinicians in payment models that focus on better health outcomes and coordinated, high quality care.”
Specific to the Shared Savings Program
The Shared Savings Program was established by section 3022 of the Affordable Care Act and is a key component of the Medicare delivery system reform initiatives included in the Affordable Care Act. Shared Savings Program ACOs are groups of doctors and other health care providers who voluntarily work together with Medicare to provide high quality services to Medicare fee-for-service beneficiaries. In 2017, the Shared Savings Program welcomed 99 new participants and 79 renewing participants, bringing the total number of participants to 480 across 50 states, the District of Columbia, and Puerto Rico. CMS also recently announced a new Medicare ACO Track 1+ Model for 2018 that will test a payment design that incorporates more limited downside risk than is currently present in Tracks 2 or 3 of the Shared Savings Program in order to encourage more practices, especially small practices and small rural hospitals, to advance to performance-based risk.
Doctors, hospitals, and health care providers establish ACOs to work together to provide higher-quality coordinated care to their patients, while helping to slow the growth of health care costs. CHPA is one of 480 ACOs participating in the Shared Savings Program, as of January 1, 2017. Beneficiaries seeing health care providers in ACOs always have the freedom to choose doctors inside or outside of the ACO. ACOs have the opportunity to receive a portion of the Medicare savings generated from lowering the growth in health care costs as long as they also meet standards for high quality care.
Since ACOs first began participating in the Shared Savings Program in early 2012, thousands of health care providers have signed on to participate in the program, working together to provide better care to Medicare beneficiaries.
For the Shared Savings Program Fact Sheet and a list of the new and renewing ACOs announced, visit the Shared Savings Program News and Updates webpage.
ACOs Improve Quality and Reduce Costs While Preserving Medicare Beneficiary Choice of Providers
Full press release linked here: CHPA Press Release 10/1/2020
Denver, Colorado— Community Health Provider Alliance (CHPA) improved care for 15,510 Medicare beneficiaries in the state of Colorado and saved Medicare $7,837,130 by meeting quality and cost goals in 2019, according to recently released performance data from the federal agency that administers Medicare.
The Community Health Provider Alliance (CHPA) earned a quality score of 92.17% percent on performance measures ranging from preventive health checks to use of computerized health records to preventing avoidable hospitalizations, Medicare data show. The $7,837,130 of gross savings to Medicare resulted in a shared savings payment of $3,104,741 of shared savings payments to CHPA, which will be used for future infrastructure and reserves and 60% distributed to the Community Health Center members in the MSSP program.
For example, CHPA providers work to increase the number of Medicare beneficiaries taking advantage of annual wellness visits, including recommended screenings and preventive care. The ACO also focuses on ensuring smooth patient transitions from the hospital to home—or a nursing home if needed. All ACO providers receive detailed information about their performance on quality measures. And clinicians and providers share best practices to coordinate the care beneficiaries receive from different primary care and specialty providers and to prevent health issues and repeat hospitalizations. CHPA Community Health Centers serving Colorado includes:
Axis Health Systems
Clinica Family Health Services
Frontier Health Center
High Plains Community Health Centers
Northwest Colorado Health
Pueblo Community Health Center
Sheridan Health Services
STRIDE Community Health Centers Salud Family Health Centers
Summit Community Care Clinic
Sunrise Community Health
Valley-Wide Health Systems
A market-based solution to fragmented and costly care, accountable care organizations (ACOs) empower local Community Health Centers to work together and take responsibility for improving quality, enhancing patient experience and keeping care affordable. The Medicare Shared Savings Program (MSSP) creates incentives for ACOs to invest in transforming care by allowing them to share in savings they generate after meeting defined quality and cost goals.
In 2019, nationally 475 ACOs caring for 9,754,781 million beneficiaries participated in the MSSP, generating gross savings of $1,844,758,696 billion based on the Centers for Medicare & Medicaid Services methodology for setting financial benchmarks. After accounting for shared savings earned by ACOs in 2019, estimated net Medicare savings were $1,117,881,599 billion.
Community Health Provider Alliance (CHPA)
Since 2014, CHPA has decreased overall healthcare costs and increased patient satisfaction to our population. As a 501c3, CHPA’s integrated network has 20 FQHCs participating in various payer-specific quality improvement projects in our Medicare, Medicaid, and Commercial ACO. The network of providers includes 630 medical providers and advanced practice providers, 170 behavioral health, and 140 dental providers that operate in more than 140 locations across the state of Colorado. These providers provide care for over 852,000 lives. In total, the Colorado FQHCs provided 2.8 million medical, dental and mental health visits in 2019.
Members of CHPA must agree to work as an accountable care organization (ACO) focused on adopting and implementing best practices to improve the health and well-being for our patients. Our members agree to adopt and adhere to evidence-based clinical guidelines. Providers and clinics are required to actively participate in activities and CHPA initiatives to improve the quality, efficiency, and coordination of patient-care, including:
- Participating in clinical education, care coordination activities and regular clinical and quality improvement meetings
- Reviewing FQHC performance data and testing and demonstrating improvements and progress toward CHPA goals
- Implementing population health management strategies, including the implementation of health information technology to improve systems, care coordination, population management, and risk adjustment
- Adhering to clinical guidelines, as demonstrated by performance on nationally endorsed measures and defined performance targets
The Alliance Newsletter
Click edition of the CHPA newsletter you would like to read below: