James Nichols from RCxRules shares his key takeaways from the APG Annual Conference below.
I was thrilled to attend the APG Annual Conference earlier this month and enjoyed a productive several days in San Diego. It’s always informative to hear expert opinions on the current state and future of value-based care.
One session in particular titled "What Policymakers Need from APG Members to Advance Value-Based Care," provided great insight into the shifting focus of value-based care. Speakers Mark McClellan, MD, PhD (Director of Duke-Margolis Center for Health Policy), Purva Rawal, PhD (Chief Strategy Officer, Centers for Medicare & Medicaid Services), and Meena Seshamani, MD, PhD (Deputy Administrator and Director, Center for Medicare) provided a great overview of the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model, which is a redesign of the existing Global and Professional Direct Contracting Model (GPDC) Model.
As defined by CMS, the purpose of the ACO REACH Model is “to improve the quality of care for people with Medicare through better care coordination, reaching and connecting health care providers and beneficiaries, including those beneficiaries who are underserved.” The ACO REACH Model will go into effect for plan participants starting January 1, 2023. Session speakers heavily emphasized the importance of Health Equity to the ACO REACH Model.
The key takeaway for APG members is that policymakers will expect them to have a health equity plan moving forward. As the ACO REACH Model takes effect, CMS “will require that all model participants develop and implement a robust health equity plan to identify underserved communities and implement initiatives to measurably reduce health disparities within their beneficiary populations.”
The government’s initial focus with value-based care was on improving the quality of care. Now that the healthcare industry has become more comfortable with value-based care, the focus is shifting to achieving health equity. Medical organizations in turn need to focus on finding a way to provide the same level of care regardless of socioeconomic factors.
An important part of executing these programs is ensuring that ACOs are equipped to accurately and completely code all diagnoses for their members. RCxRules can help streamline this process through automation that improves HCC coding and facilitates the capturing of HEDIS quality measures.
To learn more about how RCxRules can help your ACO, set up a 15-minute meeting.