HHAs Recognized as Preferred Providers for Next Generation ACOs

Here’s the question of the day:

” Please describe how reimbursement for post-discharge home visits will help the Applicant organization reduce total Medicare expenditures and improve care integration, quality assurance and patient safety.”

This question could serve as a foundation for VNAA’s strategic policy activities. In reality, The Centers for Medicare and Medicaid Services (CMS) poses this question on the application for Next Generation Accountable Care Organization (ACOs) and reveals that, at least within CMMI, there is recognition of the considerable value in partnering with home health providers.

CMS yesterday revealed details on the “next generation” of accountable care organizations that aim to lower cost and improve quality through enhanced coordination of care and patient engagement. The new models will take on much more risk than earlier models including the Medicare Shared Savings Program (MSSP) and Pioneer ACOs. Importantly, the new models will encourage patient engagement by offering rewards when a person gets care from an ACO provider, CMS says. ACOs will be paid for “skilled nursing care without a prior hospitalization,” telemedicine services no matter where the patient lives and post-discharge home services to support care there. Specifically, Next Generation ACOs will be offered waivers for home visits to non-homebound aligned beneficiaries.

Next Generation ACOs will have 40 quality measures, many of which can be impacted by home health providers. HHAs seeking to partner with ACOs, regardless of model, should understand and demonstrate performance on many of these measures.

CMS seeks between 15 and 20 ACOs to participate and requires a minimum of 10,000 beneficiaries. The first round of applications will be due June 1, with the goal of launching within six months.