Our team traveled to healthcare conferences and events all over the U.S. this fall—from Blue Cross Blue Shield’s IM Symposium in Alabama, to the NAACOS Fall Conference in Washington, D.C., to the AHCA/NCAL Convention this week in San Diego. We gained valuable insight by spending time with our health plan, health system and ACO, and post-acute provider customers and colleagues. Here’s a brief rundown of the main themes and issues discussed at each event.
IM Symposium– The Importance of “Real-Time” Data
An annual event since 2000, the Blue Cross Blue Shield Information Management (IM) Symposium is an opportunity for data management and informatics professionals to network, share best practices, and discuss innovation in the industry. It was no surprise that the main theme at the conference was the increased importance and plan reliance on clinical data, for both population health and provider performance purposes.
BCBS plans are recognizing the value of “real-time” clinical data over retrospective claims data, and many are starting to use data from EHRs and labs to understand their members’ health status. Clinical data also allows plans to stratify their member and provider populations, so that they can understand and respond to the unique needs of high-risk members as well as evaluate provider performance. To get the full picture for Medicare and Medicare Advantage, plans need to gather and analyze trends in member data across the entire care continuum. They need tools and technology that facilitate data collection and that allow them to present measurable outcomes, not only in acute inpatient settings but also in post-acute settings like SNFs and home health.
NAACOS– A Common Desire to Change Healthcare
The National Association of ACOs (NAACOS) Fall Conference brings clinical, administrative, and executive stakeholders in the ACO world together to exchange strategies and perspectives. With more than 700 attendees and over 60 exhibitors from around the country, this event was the largest gathering of ACO professionals to date by far, and the excitement in the air was palpable. Whereas last year many of these organizations were still in the planning stages, this year attendees came with significant experience under their belts and were eager to discuss the real issues that they’re grappling with today.
There were many conversations around building preferred provider networks and how to select the right PACs. The keynote by Adam Boehler from CMMI also sparked discussion about success under risk-based models. Contrary to some recent media reports, most ACOs are not opposed to taking on financial risk. However, organizations are concerned about a one-size-fits-all approach to performance measurement, given the vast differences between patient populations, geographic considerations, and other distinguishing factors.
Despite the fact that some of the ACOs in attendance are competitors, the dominant culture was one of openness and sharing, fueled by a common desire to effect change in the healthcare system and a common belief that value-based care is the right path. This belief is backed by the data, with a recent NAACOS report on MSSP ACO savings estimating gross savings of over $1.8 billion, nearly double the CMS estimate.
AHCA –Challenges Ahead for the Skilled Nursing Industry
Last but not least, our team traveled to sunny San Diego for the American Health Care Association (AHCA) Annual Convention and Expo, where professionals from skilled nursing centers and assisted living facilities convened to share ideas about how to improve the quality of care for their increasingly acute patient population. Mark Parkinson, President of AHCA, kicked off the convention by describing how the industry is undergoing significant regulatory and payment changes, creating the greatest challenges he’s seen during his tenure.
Nationally, post-acute providers are experiencing decreasing occupancy rates as their referral partners apply pressure to reduce length of stay (LOS). Yet the “Silver Tsunami,” the wave of Baby Boomers who are expected to require skilled nursing services, is still several years out.
The big buzz during convention was how to prepare for the Patient-Driven Payment Model (PDPM), which goes into effect next year. Reimbursement under the PDPM will be based on an assessment of a patient’s needs and comorbidities when they first enter a SNF, putting pressure on providers to make sure they accurately document the patient’s situation on admission.
Last but not least, Nancy Pelosi made a surprise appearance. She applauded the industry for making improvements and thanked the caregivers in attendance for their dedication.
If we didn’t catch you at the IM Symposium, NAACOS, or AHCA, we hope to see you at another upcoming event. Check out our event schedule here.