Healthcare Matters

The Premier healthcare alliance launched a new collaborative to help health systems successfully navigate their way through the application process for the Medicare Shared Savings Program (MSSP). The MSSP program is voluntary, so providers seeking ACO status and the shared savings benefits promised through the MSSP must first complete an extensive application detailing their capabilities.

A little bit about the details requested in the application:

• ACO structure, including governance and leadership;
• Process for distributing shared savings payments;
• Financial pro formas;
• Agreements between various providers that are part of the ACO;
• Data sharing capabilities;
• Quality improvement plans;
• Clinical processes;
• Patient engagement strategies.

NOTE: Knowing that your plan is compliant with Medicare’s regulations before undertaking the application process (i.e. knowing the right answers beforehand) is essential.

“Premier provided resources that helped us with a successful Shared Savings Program application,” said Associate General Counsel Robert Gerberry of Summa Health System in Akron, Ohio, who prepared the MSSP application for NewHealth Collaborative, an ACO launched by Summa and a group of northeast Ohio physicians. “Through Premier, we had direct access to representatives from the Centers for Medicare & Medicaid Services for application questions, opportunities to speak with other healthcare organizations going through the same process, and exceptional consulting expertise as we drafted our application.”

To prepare for MSSP applications, Premier offers all collaborative participants:

• An MSSP pre-assessment tool;
• A comprehensive gap analysis based on application requirements;
• Application support, including sample documents related to governance and provider participation, a narrative template and question and answer sessions; and
• Access to best practices and lessons learned from successful applicants.

“Given the short time frame for developing MSSP applications, it is imperative that interested ACOs start executing now,” said Joe Damore, vice president of integrated engagement and delivery and head of the MSSP collaborative. “We have a strong track record of success in previous MSSP application rounds and believe that we can help almost any organization successfully develop a winning proposal.”

Collaborative members will also benefit from Premier’s clinical, financial and operational comparative databases, containing 1 in 4 patient discharges and close to $43 billion in annual purchasing data. They use this information to enable data-driven, evidence-based decisions to improve quality, reduce costs and coordinate care delivery.

Premier is accepting new members to join the MSSP collaborative for the next available contracting period, which begins on January 1, 2013. Applications for the next round of contracting must be completed and submitted to the Medicare program by September 6, 2012, to be considered. Those interested in participating can learn more on the Premier website.

Practical support of the application process is just a good idea/nice value added service provided by Premier. But qualifying for ACO status and maximizing the benefits of the shared savings program are not the same thing. Not to oversimplify, but qualifying (relatively speaking) requires the ability to provide the right answers in an open book test format. Maximizing compensation, however, will be driven by actual performance. That’s where those Premier databases could prove invaluable to providers making the ACO bet. For those who embrace the knowledge they contain, there’s a performance template –an optimized compensation model– buried therein.

Source: PRNewsWire, Premier.

—Tom Finn