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The Centers for Medicare and Medicaid Services (CMS) has announced a redesigned Accountable Care Organization (ACO) model that better reflects the agency’s vision of creating a health system that achieves equitable outcomes through high quality, affordable, person-centered care. The ACO Realizing Equity, Access, and Community Health (REACH) Model, a redesign of the Global and Professional Direct Contracting (GPDC) Model, addresses stakeholder feedback, participant experience, and Administration priorities, including CMS’ commitment to advancing health equity.
In addition to transitioning the GPDC Model to the ACO REACH Model, CMS is canceling the Geographic Direct Contracting Model (also known as the “Geo Model”), effective immediately. The Geographic Direct Contracting Model, which was announced in December 2020, was paused in March 2021 in response to stakeholder concerns. A comparison table of ACO REACH and GDCM is available for additional information.
CMS, through the Innovation Center, is testing new models of health care service delivery and payment to improve the quality of care that people receive, including those in underserved communities. The Innovation Center is making improvements to existing models and launching new models to increase participation in our portfolio, and CMS will be a strong collaborator to health care providers that participate in those models.”
As CMS works to achieve the vision outlined for the next decade of the Innovation Center, CMS wants to work with partners who share its vision and values for improving patient care, guided by three key principles. First, any model that CMS tests within Traditional Medicare must ensure that beneficiaries retain all rights that are afforded to them, including freedom of choice of all Medicare-enrolled providers and suppliers. Second, CMS must have confidence that any model it tests works to promote greater equity in the delivery of high-quality services. Third, CMS expects models to extend their reach into underserved communities to improve access to services and quality outcomes. Models that do not meet these core principles will be redesigned or will not move forward.
REACH ACOs will be responsible for helping all different types of health care providers — including primary and specialty care physicians — work together, so people get the care they need when they need it. In addition, people with Traditional Medicare who receive care through a REACH ACO may have greater access to enhanced benefits, such as telehealth visits, home care after leaving the hospital, and help with co-pays. They can expect the support of the REACH ACO to help them navigate an often complex health system.
The GPDC Model will continue until December 31, 2022, and then will transition to the ACO REACH Model. The first performance year of the redesigned ACO REACH Model will start on January 1, 2023, and the model performance period will run through 2026. CMS is releasing a Request for Applications for provider-led organizations interested in joining the ACO REACH Model. Current participants in the GPDC Model must agree to meet all the ACO REACH Model requirements by January 1, 2023, in order to participate.
A Financial Management Services (FMS) stakeholder meeting has been scheduled for March 4, 2022, from 1:00 pm–2:30 pm. This public meeting will include a discussion on the upcoming changes for the administration of FMS under the Community HealthChoices (CHC), OBRA Waiver, and Act 150 Programs. Representatives from both the CHC Managed Care Organizations (MCOs) and the Office of Long-Term Living (OLTL) will be in attendance to discuss the upcoming changes.
Registration is required to participate. Once registered, participants will receive a confirmation email containing information about joining the webinar.
If you choose to use your phone to call in, please use the numbers below:
Dial in: (562) 247-8321
Access Code: 625418280#
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The Office of Long-Term Living (OLTL) has updated its guidance about payments to strengthen the home and community-based services (HCBS) workforce and assist Adult Day Service (ADS) providers. The updated Frequently Asked Questions (FAQ) document is available under the “Strengthening the Workforce” heading on the DHS Long-Term Care Providers page.
To maximize the use of federal funding under Section 9817 of the American Rescue Plan Act (ARPA) of 2021, OLTL has moved the date by which providers must spend “Strengthening the Workforce” and “Adult Day Services” funds from March 31, 2024, to October 1, 2023. This change allows sufficient time for providers to file an expenditure report and return unspent funds as applicable. OLTL will offer additional details about ARPA expenditure reporting in coming months.
Providers that have questions about this information should contact the OLTL Provider Helpline at 800-932-0939.
The Department of Human Services’ (DHS) Division of Adult Protective Services (APS) developed a media toolkit designed for facilities, mandatory reporters, and community members to assist in the awareness of abuse, neglect, exploitation, and abandonment of adults ages 18 to 59 living with a disability within the Commonwealth. Learn more about APS and use these resources to help promote APS to your clients, constituents, and network at the Adult Protective Services Media Toolkit web page.
Additionally, there are several dates (that are subject to change) where DHS will be publishing different social media posts that everyone is encouraged to share. These are available at the Adult Protective Services Media Toolkit web page on:
Questions regarding the materials found in the APS Media Toolkit or suggestions of additional resources that might be helpful in promoting the program should be directed to the APS Division.
A Financial Management Services (FMS) Stakeholder meeting has been scheduled for February 18, 2022, from 1:00 pm–2:30 pm. This public meeting will be held to discuss upcoming changes for the administration of FMS under the Community HealthChoices (CHC), OBRA Waiver, and Act 150 programs. Representatives from the Office of Long-Term Living (OLTL) and CHC Managed Care Organizations (MCOs) will be in attendance to discuss these changes.
Those interested in participating should register prior to the meeting. After registering, a confirmation email will be sent containing information about joining the webinar.
If you choose to use your phone to call in, please use the numbers below:
Dial in: 1 (415) 930-5321
Access Code: 159291259#
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The next Managed Long-Term Services and Supports (MLTSS) Subcommittee meeting will be held on March 1, 2022, as a webinar from 10:00 am–1:00 pm.
You can register for the meeting here. After registering, you will receive a confirmation email containing information about joining the webinar. Remote captioning and streaming services will be provided; if you require these services, please visit here. If you require another accommodation, including an alternative method for submitting questions or comments about meeting topics, please send an email no later than February 18, 2022, so other accommodations can be scheduled.
On February 2, 2022, the monthly Managed Long-Term Services and Supports (MLTSS) Subcommittee held their monthly meeting. The handouts referenced and shared during this monthly meeting are provided below:
The next MLTSS Subcommittee meeting is scheduled for March 1, 2022.
The Centers for Medicare and Medicaid Services (CMS) has released the updated Inpatient Rehabilitation Facility (IRF) Provider Preview Reports. These reports contain provider performance scores for quality measures and contain data submitted by IRFs from Quarter 3 (Q3) 2020 through Quarter 2 (Q2) 2021.
Providers have until February 25, 2022, to review their performance data. Providers can request CMS review their data during the preview period if they believe the scores are inaccurate. The final reports will be published on Care Compare and Provider Data Catalog (PDC) during the March 2022 refresh of the websites. For additional information, visit the CMS IRF QRP Public Reporting website.