Becker's ASC Review

44 HEALTHCARE NEWS CMS gives ACO model a makeover: 7 things to know By Marissa Plescia I n an effort to improve health equity, CMS has changed to the Global and Profession- al Direct Contracting model aer receiv- ing stakeholder feedback, it said Feb. 24. Hundreds of healthcare organizations wrote to HHS Secretary Xavier Becerra Feb. 14, urging HHS to refine the model rather than scrap it. Seven things to know about the new model: 1. CMS is requesting applicants to participate in the new model, which will be renamed to the Accountable Care Organization Real- izing Equity, Access, and Community Health model, or ACO REACH. e new name is based on the model's purpose to encourage healthcare providers to improve care for people using Medicare. 2. With the redesign, the Geographic Direct Contracting model will be permanently canceled, a move announced in December 2020, and paused in March 2021. It is being canceled because of stakeholder concerns, CMS said. 3. e ACO REACH model has three main principles. e first is to improve health equity and bring the benefits of accountable care to underserved areas. CMS will do this through better support care delivery and will require model participants to create a health equity plan to be implemented in under- served communities. 4. e second principle is to promote pro- vider leadership and governance, which will make sure doctors and healthcare providers play a vital role in accountable care, ac- cording to CMS. At least 75 percent of each ACO is to be controlled by participating providers and their designated representa- tives; the Global and Professional Direct Contracting model only required 25 per- cent. It also requires at least two beneficiary advocates on the governing board, with one being a Medicare beneficiary and one a consumer advocate. 5. e third principle is to protect beneficia- ries and the model through more partici- pant vetting, monitoring and transparency. More information on applicants' owner- ship, leadership and governing board will be required. ere will be more up-ront screening of applicants, monitoring of par- ticipants and more transparency while the model is implemented. ere will also be stricter protections against incorrect coding and risk score growth. 6. To improve transparency, CMS will share the following information at the participant level about the Global and Professional Direct Contracting model for the remainder of this year and will do the same with ACO REACH: type of entity, risk-sharing arrange- ment, payment option, benefit enhance- ments and beneficiary engagement incen- tives they have elected to use, organization website and core service area. 7. e Global and Professional Direct Con- tracting model will continue until Dec. 31, 2022, and ACO REACH will begin Jan. 1, 2023. Participants in the Global and Profes- sional Direct Contracting model will have to meet requirements for ACO REACH by Jan. 1, 2023 to continue to participate. n HHS: Make cybersecurity a priority By Naomi Diaz T he director of the Office for Civil Rights at HHS urged HIPAA- covered healthcare entities to patch up vulnerabilities that give hackers easy access to organization's computer servers. According to a Feb. 28 HHS blog post, healthcare organizations' cyber- security issues were more turbulent as hackers took advantage of hos- pitals and healthcare systems responding to the COVID-19 pandemic. To combat these attacks, HHS encourages healthcare entities to do the following: • Have an offline, encrypted backup of data and regularly test your backups. • Know where all your EHR information is stored and exists across your organization. • Conduct regular scans to identify and address vulnerabilities, especially those on internet-facing devices. • Continuously update software and operating systems. • Train employees on all possible IT attacks. n UnitedHealthcare ends paper prior authorization letters By Patsy Newitt U nitedHealth Group has decided to stop mailing prior authorization and clinical decisions to providers on paper. The move took effect March 4 for most UnitedHealthcare Medicare Advantage and commercial plan members. Providers can view the decisions digitally immediately after they are made instead of receiving a mail appeal decision. The decision comes after UnitedHealth Group pledged to increase its commitment to sustainability in late 2021. n

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