5 Takeaways From the NAACOS Fall 2016 Conference

If the growing membership of the National Association of Accountable Care Organizations (NAACOS) is any indication, healthcare delivery reform is being embraced by the United States. Membership has grown 33% just since Spring 2016.

During the fall meeting in Washington, DC, speakers from the government and from various ACOs across the country shared their insights into the success and opportunities of these delivery models. Here are 5 takeaways from the NAACOS fall conference.

1. It’s time to start acting like ACOs are here to stay

Ending the attitude that payment and delivery reform changes are short-lived or just in the testing phases is a sentiment that JAMA published 2 weeks ago. Jeff Spight of Universal American echoed that opinion during the first plenary at NAACOS. He explained that while the designation of “ACO” may change, what it stands for will endure.

“For the longest time this has been an experiment, a pilot, a try: ‘We’re going to test things,’” Spight said. “I think we need to pivot from that to become a permanent part of the healthcare delivery system.”

2. ACOs are performing better than people give them credit for

Recent results from the Medicare ACO programs showed that less than one-third generated shared savings, but the age of an ACO plays a huge part in how successful it is, explained Sean Cavanaugh, deputy administration and director of the Center for Medicare at CMS. He reported that 42% of ACOs that started in 2012 shared in savings.

“As we go through time we see more and more ACOs sharing in savings,” Cavanaugh said.

3. Healthcare transformation is difficult

A healthcare system that supports people to keep them as healthy as possible may be the goal, but getting there is not easy. It will require constant change and removing a lot of barriers in place.

“Transformation takes time,” said Patrick Conway, deputy administrator for Innovation & Quality and chief medical officer at CMS. “It’s a long journey; it’s not a sprint.”

However, transformation is taking place. Conway noted that there has been more change in healthcare delivery in the last few years than in decades.

4. The physicians must be on board

This is a sentiment that gets said at all of these types of meetings, but since physician buy in is so critical to the success of not only ACOs, but healthcare transformation as a whole, it bears repeating. David Klebonis of Doctors ACO said that the ACOs that were unable to get the physicians to change and actively participate are not around any more.

5. CMS is constantly making changes based on feedback

Cavanaugh and Conway were the highlights of day 1 of the conference, and both discussed how much work there is left to do. Cavanaugh discussed the June 2016 final rule that took into account ACO concerns and suggestions to compare them to their own region. The new rule moves away from comparing ACOs to their own history, which made it increasingly difficult to perform well enough to generate shared savings.

Conway added that CMS is listening as it finalizes rules for the Medicare Access and CHIP Reauthorization Act. The new system represents a huge change in reimbursement as it sets up the merit-based incentive program and alternative payment models with a 5% bonus payment, and government officials have met with more than 60,000 people as part of the rule-making process.