NCMS Morning Rounds 10-2-19

Welcome to Wednesday and your

 NCMS Morning Rounds!

Oct. 2, 2019

Quick Survey on Health Care Issues in the News

The NCMS’ LEAD Health Care Conference starts tomorrow, bringing together your colleagues from across the state to learn, socialize and help NCMS leaders in their policymaking by engaging in substantive discussion around issues important to you.

In an open forum discussion at the Annual Business Meeting on Friday, NCMS President Timothy J. Reeder, MD, MPH, FACEP and NCMS President-elect Palmer Edwards, MD,  will facilitate dialogue on issues determined by NCMS members.

With a newly developed NCMS Policy Committee meeting in the days following the LEAD Conference, the NCMS will gauge member opinion of health issues in the news with onsite electronic polling. To provide initial feedback and suggest discussion issues, please take this brief member survey.


“The NCMS Board of Directors is only as effective as the level of dialogue shared with our members,” says Dr. Reeder. “Join us for this annual opportunity to meet new colleagues and share your voice with your professional organization.”

Online registration for the conference closed last week, but if you now happen to find yourself with time to attend, you can register at the door. Review the agenda. We hope to see you there!

Latest Results Reveal Strong Showing for ACOs

On Monday, the Centers for Medicare and Medicaid Services (CMS) released results for the Medicare Shared Savings Program (MSSP) for the 2018 performance year showing a strong trend toward saving Medicare money and achieving high quality. Review the data.

The Shared Savings Program is a voluntary program that encourages groups of doctors, hospitals and other health care providers to come together as an Accountable Care Organization (ACO) to lower growth in expenditures and improve quality. The ACO agrees to be held accountable for the quality, cost and experience of care of an assigned Medicare beneficiary population. ACOs that successfully meet quality and savings requirements share a percentage of the achieved savings with Medicare.

A preliminary analysis of the results done by the National Association of ACOs (NAACOS) found that 66 percent of MSSP ACOs had expenditures lower than their benchmarks last year and 37 percent earned shared savings. The 548 MSSP participants nationwide serve almost 11 million Medicare beneficiaries, collectively saving Medicare $1.7 billion last year alone, and $739 million after accounting for shared savings bonuses and collecting shared loss payments. MSSP ACOs also had an average quality score of almost 93 percent, according to the NAACOS analysis.

In an online Health Affairs article, CMS Administrator Seema Verma wrote that the 2018 results support changes made to the program through the ‘Pathways to Success’ initiative. This puts ACOs on a quicker path to taking downside risk and offering ACOs more flexibility to coordinate care and innovate, Verma said.

She also noted: “performance data for 2018 also shows that ACOs led by physicians (which tend to be “low-revenue” ACOs since they provide mostly outpatient services) continued to perform better than ACOs led by hospital systems (which tend to be “high-revenue” ACOs since they provide inpatient and outpatient services). In 2018, low-revenue ACOs showed an average reduction in spending relative to targets of $180 per beneficiary, compared to just $27 for high-revenue ACOs.”

Read Verma’s article.

The NCMS has long been involved in offering support and resources for ACOs through gatherings like our Population Health Collaborative and our downloadable toolkits. Learn more.

Stay tuned to your NCMS Morning Rounds for specific information on North Carolina’s MSSP ACOs and performance data for Next Generation ACOs, which hasn’t been released to the public yet.

Kudos to Dr. Mattson!

Congratulations to NCMS Foundation Board of Trustees President and Kanof Institute Leadership College Co-Chair Gerri Mattson, MD, MSPH, FAAP on receiving the NC Public Health Association’s 2019 Distinguished Service Award. Award nominations are made by the NCPHA Executive Committee and the award is given to honor a deserving NCPHA member for their distinguished service to the organization.

Dr. Mattson serves on the NCPHA Governing Council Women’s and Children’s Health Section.

Congratulations, Dr. Mattson!

In the News

Only 52 % of Adults Plan to Get the Flu Vaccine this Season, Survey Finds, Becker’s Hospital Review, 9-27-19

Learning Opportunity

The NCMS Foundation’s and NC Medical Group Management Association’s Lunch & Learn Webinar: ‘The Rise of Artificial Intelligence (AI) and The Future of Physician Practices,’ will be held on Oct. 15 from noon to 1 p.m. The presenter will be Sam Cohen, JD, MPP, Curi’s Senior Vice President for Health Policy. Curi, a Medical Mutual Company, is a sponsor of the webinar. Cohen uses his health policy knowledge and his background as a healthcare attorney to help physicians and medical practices navigate the opportunities and risks presented by the many changes to the healthcare environment. Learn more and register.


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1 Comment

  • Elaine Ellis

    In response to the article ‘Latest Results Show Strong Showing for ACOs,’ I always cringe a bit when I see a comment like: “performance data for 2018 also shows that ACOs led by physicians (which tend to be “low-revenue” ACOs since they provide mostly outpatient services) continued to perform better than ACOs led by hospital systems.”

    I think there are examples, both nationally and in North Carolina, that demonstrate that ACO’S with hospital partners truly dedicated to value can be very successful as they can often better coordinate care across the historically expensive and disjointed medical silos that developed in a fee-for-service world. True success in value based care, whether it is with physician-only or hospital/physician ACO’s, depends on how dedicated and engaged the participants are on a daily basis when they are interacting with patients.

    Brian Klausner, MD