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ICYMI: Notes from the field for March 2020

DATE: April 1, 2020

The COVID-19 pandemic dominated media and “mindshare” this month and for good reason. Here are the news stories that caught our attention.

The massive impact of COVID-19

  • The outbreak of COVID-19 has resulted in the cancellation of elective surgeries, something that many participants in the Comprehensive Care for Joint Replacement and Bundled Payments for Care Improvement-Advanced programs fear could hurt their ability to succeed in these initiatives. While there’s been no word from CMS yet, participants are hopeful that CMS will adjust targets to compensate for this unprecedented situation.
  • That hope rests in part on the fact that CMS has already relaxed the quality reporting requirements for other alternative payment models, such as the Merit-based Incentive Payment System and Medicare Shared Savings Program, to account for the COVID-19 pandemic.
  • COVID-19 is also troubling to participants in Accountable Care Organizations, which fear that they could see their hard-earned savings wiped out by the pandemic. The National Association of ACOs is calling on policymakers to put protections in place for value-based programs.
  • The recently enacted Coronavirus Aid, Relief, and Economic Security (CARES) Act is offering an avenue for Medicare-reimbursed providers to request accelerated payments to help cover the cost of caring for COVID-19 patients.
  • Industry stakeholders are calling on CMS to delay the start of the new radiation oncology bundle to ensure there are enough resources available to respond to COVID-19 patients. The program is slated to start this summer, but the American College of Radiology is calling for the program to be delayed by at least six months.

Some trepidation around new bundles

  • CMS’ proposed new oncology bundled payment model, Oncology Care First, drew some reactions from a group of leaders from community oncology practices. They have asked that the tracking of patient-reported outcomes with digital tools requirement be phased in to allow more time for smaller oncology practices to prepare.
  • But fears over the need to add new tech aren’t the only concern providers are voicing about OCF. That’s partly due to the fact that CMS unexpectedly released the details about OCF, leaving many providers scrambling to understand the changes, according to a recent article in Pharmacy Practice News.
  • Meanwhile, the proposed new rule for the CJR program is drawing mixed responses. Representatives from the American Association of Orthopaedic Surgeons released a statement welcoming some of the changes, but expressed concern about the potentially mandatory nature of the program and a lack of appropriate focus on physician leadership.

 Other news

  • Our recent market study on healthcare leaders’ perceptions around the future of value-based care received coverage from RevCycleIntelligence, Health Leaders and Becker’s Hospital Review, among others. If you haven’t had a chance, read the report
  • Some interesting formal education opportunities are arising to help providers make the most of value-based care initiatives. Will they help more healthcare organizations successfully transition to these programs?