Providers that take part in alternative payment models are more likely to use population health strategies to address the COVID-19 pandemic than non-participants, according to a survey by consultancy and group purchasing organization Premier Inc. on Wednesday.
More than 80% of APM participants use care management support to deal with COVID-19 patients compared to just half of providers that aren't in APMs. And about half of providers in APMs use triage call centers and remote monitoring, while less than a third of non-participants do.
APM providers are significantly more likely to "use population health data to manage and predict cases," according to Premier Inc. They're also more than twice as likely to use claims data to monitor non-acute care relative to providers that don't participate in APMs.
"Respondents participating in APMs had a significant head start over other healthcare providers in being able to provide quality and preventive care for their covered lives, all while managing an influx of emergency COVID-19 cases," Joe Damore, vice president of population health for Premier Inc., said in a statement.
Providers that take part in value-based payment models like APMs are worried that they will experience large financial losses due to the COVID-19 outbreak, even though they had little ability to manage their population risk. Premier's survey aims to show that providers deserve relief because they're doing more to address population health than other providers.
Hospitals and other stakeholders have asked CMS to grant relief to APM participants, arguing that providers may become unwilling or unable to participate without it. They're asking for several breaks, including the elimination of downside financial risk and accelerated shared savings and MACRA bonus payments. Providers also want to get paid for reporting quality measures instead of quality performance. And they want to be able to change tracks if they're in an accountable care organization.
But many experts believe it's impossible to know the impact of the pandemic on Medicare spending right now. They're concerned that the proposed adjustments to 2020 Medicare spending and benchmarks is impractical and could unfairly reward certain providers. In April, the Medicare Payment Advisory Commission—MedPAC—recommended that CMS toss out 2020 data when it determines ACO performance or assigns beneficiaries.
"ACOs should focus on their response to COVID-19 without concern for shared ACO savings or losses," MedPAC said in an April letter to CMS.
The National Association of ACOs clapped back, arguing that ACOs use shared savings to "to pay for quality improvement programs, care coordinators, health IT, analytics and other infrastructure" necessary to improve quality and manage chronic diseases.
