NCMS Morning Rounds 7-24-19

Happy Wednesday! It’s time for your

 NCMS Morning Rounds.

July 24, 2019

Connecting Patients to Non-clinical Help: An Update on NCCARE360

North Carolina is the first state in the country to have a technology platform connecting physicians and other health care providers with the community resources to address patients’ non-clinical needs like food insecurity, transportation and others. The second quarterly report for NCCARE360, the mechanism that allows this coordinated care, was recently released and shows that networks have been launched in 12 counties thus far with nine more in the implementation process. The program is on track to be present in all 100 counties in the state by the end of 2020. Review the report.

The report also shows that through referrals to the participating organizations, 216 individuals have been helped thus far through NCCARE360, which launched in January 2019.

Research shows that up to 80 percent of a person’s health is determined by social and environmental factors, and the behaviors that are influenced by them. NCCARE360 is designed to address those factors, much like the NCMS Foundation’s Our Community Health Initiative (OCHI) currently is seeking to connect patients with community based organizations and services like diabetes prevention programs in their community. OCHI is part of NCCARE360 and has received referral requests. Learn more about OCHI.

News on the Move-to-Value Front

Last Wednesday, the Centers for Medicare and Medicaid Services (CMS) announced the ACOs nationwide that will be participating in the Medicare Shared Savings Program (MSSP) as of July 1, 2019, including those participating in the new “Pathways to Success” structure. Review the data here.

This data set shows 13 ACOs with service areas in North Carolina, including Coastal Carolina Quality Care in New Bern, Physicians Healthcare Collaborative in Wilmington (commonly known as Wilmington Health) and Duke Connected Care in the Triangle area, which all had initial start dates of at least five years ago.

Of the 518 MSSP ACOs nationwide in 2019, approximately 40 are new ACOs and 152 (29 percent) are participating in two-sided risk tracks. This year’s new ACOs brought about 400,000 new beneficiaries into the program. CMS made changes to the program last year including reduced opportunities for shared savings and an accelerated track to accepting financial risk for the ACOs.

The National Association of ACOs’ (NAACOS) initial analysis of this latest report showed that “While these numbers represent a smaller number of new ACOs and an overall drop in MSSP participation from the 561 we saw in 2018, NAACOS hopes this is only a reflection of an off-cycle start date and not an indication that the program and transition to value are slowing down. NAACOS congratulates ACOs that are continuing and joining the program.”

CMS Administrator Seema Verma wrote in a Health Affairs blog post upon release of this information that “today’s results show that American providers are ready for the value-based transformation and are willing to accept greater accountability in exchange for more flexibility.” Read the blog post.

The next opportunity to join the MSSP will be in January, when the program returns to its typical schedule of ACOs joining at the start of the calendar year. More information on that application process, which opened July 1, can be found on the CMS website.

Before and After NCMS Disaster Relief

Sound Medical Family Practice was hit hard by Hurricane Florence last fall. The roof of the practice’s Morehead City office was damaged and the flooring in the Cape Carteret location was ruined due to flood waters. But thanks to the NCMS Foundation Disaster Relief Program the practice now is enjoying fully repaired and updated facilities.

“Please accept our sincere thanks for the two separate financial gifts that were made to Sound Medical in the wake of Hurricane Florence,” wrote Sandy Rickabaugh, the pratice’s business manager. “The assistance toward the new Morehead City roof and the new Cape Carteret flooring is deeply appreciated and helped make a very difficult time in our county and in our practice feel like there were positive days ahead for us. We thank you for your efforts in supporting small, primary care offices like Sound Medical as we navigate the challenges of the current medical landscape.”

Since Hurricane Florence hit eastern North Carolina last fall, 14 individual disaster relief grants ranging from $2,500 to $60,000 and totaling $270,063, have gone to practices in areas hardest hit by the storm in Whiteville, Wilmington, Morehead City, Burgaw, Goldsboro, Jacksonville and Angier. Five more awards totaling $42,500 have been approved by the NCMS Foundation’s Disaster Relief Grant Review Committee and will be distributed this month.

This help is possible thanks to the generous contributions from physicians, physician assistants and other individuals in North Carolina and nationally, and through support of The Physicians Foundation and Blue Cross and Blue Shield of North Carolina.

As insurance claims are still being processed, recovery efforts drag on and applications for Disaster Relief funds from the NCMS Foundation are still being accepted. Access the guidelines and application form.

In the News

97 percent of MIPS Clinicians Received a Bonus for 2020 – But Don’t Expect a Big Payout, The Advisory Board Forum, 7-17-19

Learning Opportunity

Today and tomorrow, Wednesday, July 24 and Thursday, July 25, the Centers for Medicare and Medicaid Services (CMS) is offering a webinar titled ‘Patient-Centered Quality Measurement: What It Is and How to Get Involved.’ The webinar will provide an overview of key concepts regarding quality measures, including how measures are developed to be patient centered. Additionally, the presentation will review opportunities for patients, caregivers and other interested stakeholders to get involved throughout the measure development process, emphasizing how this fits into CMS’s quality goals, including the Meaningful Measures initiative.

Register for
Wednesday, July 24, 2-3 pm here
Thursday, July 25, 3-4 pm here (note: this will be the same presentation as 7/24)


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1 Comment

  • John R. Dykers, Jr., MD, ME (retired)

    Would like to give a boost to those applying to be medical examiners in their county. I served from the inception of the program (I forget the year? late 60s, early 70x??) until retirement in 2010. The knowledge acquisition from the Chief Medical Examiner’s office, both in classes and in learning from each case by talking with CME pathologists, both on cases needing and not needing an autopsy, was practical, steep, enlightening, and surprisingly often applicable to the practice of medicine. I did the death reviews at our hospital and nursing home in addition to the ME cases, and brought that knowledge to the Thursday Morning Intellectual Society, our Continuing Medical Education program at Chatham Hospital, to initiate programs that were applicable to what was really happening in our community.
    The Medical Examiner cases ranged from the routine “waking up dead” to the devastating crash of the “Golden Knights” ? army paratroopers scattered through the woods of Chatham County, a multiple homicide in a home invasion, telling the difference between death from an awful car crash to simply died while driving, recognizing the importance of ‘clearing the scene’ on a highway to prevent another accident vs what I would really contribute having them wait for my inspection; learning to use the eyes of experienced EMT’s, Highway Patrol and Sheriff Deputies and Police, to make judgements that would be valid for the State Medical Examiner system. Medical Examiners will have to be able to compartmentalize traumas as well as the sadness common to simply dying, in many of these cases unattended, even if peaceful. Your monetary compensation is not for only filling out a form, but for applying judgement that will improve with each case. The breadth this experience will present you is unmatched.
    John R. Dykers, Jr. MD, ME, retired