New Payer Announcement: FrontPath

Access Advantage is excited to announce a new addition to our roster of Payers, FrontPath.
FrontPath Health Coalition, based in Perrysburg, Ohio, is a Self-Insured Plan covering individuals and their families in NW Ohio, NE Indiana and SE Michigan. The Coalition was founded in 1988 by eight Fortune 500 employers to provide a competitive alternative to traditional health insurance plans and HMOs.

For our Access Advantage Member’s outside the immediate FrontPath geographic areas, payer participation provides access to FrontPath enrollees traveling outside their immediate service area, and assures payer participation if the Plan expands to cover additional territory.

For more information feel free to connect with Renee Cummings at reneec@accesselite.com.

 

Access Innovations featured in Press Release

We are proud to provide a spotlight to our Vice President of Value Based Programs, Bryce Henson, for being featured in a press release focusing on a collaboration between MCG Health and Cadalys. MCG Health, a leading provider of informed care strategies and part of the Hearst Health network, has partnered with Cadalys, an innovator which provides Salesforce expertise, to develop an app that is empowering businesses to connect with  their customers, partners and employees in new ways while enhancing communication and streamlining workflow across organizations. Please see this exciting article through the link below!   https://www.prweb.com/releases/2018/05/prweb15517120.htm

Download our FREE eBook: OHIO MEDICARE ADVANTAGE PAYER REPORT

CMS Announces BPCI Advanced for Hospitals and Physicians- Submissions Due March 12th

CMS has announced the long awaited BPCI Advanced, modeled for hospital and physician participation.  The 2.0 version of BPCI, Advanced builds on outcomes of the Models 1-4 BPCI Pilot concluding Q3 2018.

Quick synopsis:

  • CMS applications are accepted January 11-March 12, 2018.
  • BPCI Advanced is an Advanced Alternative Payment Model (APM) under the Quality Payment Program.
  • A voluntary model, BPCI Advanced can coexist in CJR or other CMS Pilot locations.
  • It includes options for 29 inpatient episodes (105 different DRGs)
  • New inclusions are 3 outpatient episodes (30 HCPCS codes)
  • It’s a retrospective model.
  • Target prices are based on participant historic costs- based on a 4 year baseline (2013-2016) with a rolling 3-year baseline every performance year going forward, updated annually.
  • Reconciliation will occur every 6 months.
  • There are 7 quality performance measures, with adjustments to results.
  • A 5 year Pilot; BPCI Advanced runs October 1, 2018 to December 31, 2023.
  • A 2nd application period is set for January 1, 2020.
  • Interested applicants must file with CMS by March 12th for inclusion.
  • CMS will then provide claims data and target prices for decision making specific to inclusion and choice of episodes.

What are the opportunities?

File by March 12thAccess Innovations prior BPCI Pilot filing yielded extraordinary insights via Medicare claims data, not easily available to providers. We were able to assess opportunities with our prospective participants, identify risk and dialogue with about strategic market relevance for proceeding in the Pilot.  Reviewing your data is a smart first step for all providers interested in care and payment redesign opportunities.  Analysis and consultation fees are nominal.  The opportunity to review and understand your specific claims data is invaluable.

Look closely at Post-Acute Spend:  Access Innovations has historic expertise in Post-Acute Spend where most acute care providers are least focused.  Our model builds on PAC/acute aligned evidence based practices, uses progressive PHI protected IT for care coordination at home and engages on deep Post-Acute culture change.

Engage Like-Minded Providers as Care Partners: Care coordination works when alignments around shared care delivery goals exist.  Access Innovations expertise in identifying high performing Post Acute Care providers will help drive care alignments that will work.

For more information on BPCI Advanced, contact Bryce Henson, bryceh@accesselite.com or at 614-345-5001 x 208.