What We're Watching: April 30, 2019

THE CALL TO ACTION IS GETTING LOUDER

House Energy and Commerce Committee leaders are calling on CMS and other federal agencies to step up efforts to address the rising rate of maternal mortality. The lawmakers referred to last year’s enactment of the Preventing Maternal Deaths Act as a good “first step.” Additionally, the CDC released an analysis revealing that 11.5 percent of pregnant women in the U.S. consumed alcohol in the last 30 days, up from 10.2 percent between 2011 and 2013.

What we’re saying: Earlier this month, Premier launched the Bundle of Joy™ campaign to raise the bar on the quality and cost of care for mothers and babies. Premier has detailed data on 1.2 million annual births to help providers analyze care delivery and compare outcomes and practices. Marrying this information with Premier’s vast network of health systems, physicians and industry partners, as well as proven best practices, our goal is to develop, test and scale new standards in maternal care delivery.

ABOUT THOSE PAYMENT MODELS

Last week Medicare sent a clear message to providers, signaling a shift away from fee-for-service (FFS) models to those that will ensure accountability for total cost and quality of care. As part of this shift, five new, five-year voluntary payment models were rolled out. These models are the clearest departure from FFS of any Medicare model developed to date. They represent the closest Medicare FFS can come to Medicare Advantage (MA). The five year demonstrations will run from January 1, 2020 to December 31, 2025.

What we’re saying: As we mentioned last week, Premier is encouraged by the direct contracting models’ inclusion of a number of elements that we have been advocating for. Premier will be taking steps over the coming weeks to fully understand and inform its members on these models.

JUST LIKE COLLEGE APPLICATIONS (BUT NOT)

CMS is accepting applications through June 24, 2019 for the second cohort of Model Year 3 of Bundled Payments for Care Improvement Advanced. The model makes hospitals, physicians and post-acute care services providers accountable for the cost and quality of care during a 90-day episode. Participants in the model also qualify for the 5 percent MACRA bonus as an Advanced APM. Applicants may choose from 37 (33 inpatient, four outpatient) potential clinical episodes.

What we’re saying: Premier’s Bundled Payment Collaborative helps members build successful bundled payment models. We’ll be holding a webinar to provide an overview of the model and the application processon May 6th. Register here.

IN CASE YOU MISSED IT

• Is That a Bundle Behind Your ACO?
• Four Methods to Ensure Physicians are Engaged in Transformation Initiatives
• Does Your Organization Have the Right Strategic Plan?
• Three Benefits To The Oncology Care Model And Four Recommendations To Advance It
• Provider Groups Initially Enthusiastic About CMS’s Primary Care Payment Proposals
• Statement on CMS’s Announcement re: Direct Contracting Models

What We’re Watching is a weekly blog focused on the current events Premier is following and their relevance to the work of Premier and its members. Check out last week's update.