Category: News

Join Convergence Center for Policy Resolution for a virtual event, Health Starts Here: Strengthening the Policy Environment around Social Factors of Health, on Thursday, October 10th @ 1-2pm ET to hear more about the Convergence Collaborative on Social Factors of Health from Stuart M Butler PhD, Caryn Hederman, and other Collaborative Participants sharing the impact of their newly released Health Starts Here Blueprint for Action.

The Convergence Collaborative on Social Factors of Health – a group of over 40 representative stakeholder organizations and experts from health and social policy sectors – worked to identify policy actions, primarily at the federal and state levels, to foster cross-sector partnerships aimed at improving household and community health by addressing social factors of health.

The Collaborative coalesced around consensus actionable solutions in four key areas: (1) improving system integration; (2) building an SDOH workforce; (3) financing SDOH approaches; and (4) addressing data sharing, evaluation, and experimentation. These policy solutions are captured in their newly released Blueprint for Action, titled Health Starts Here.

Register for event here: https://lnkd.in/gGpWtwpq

Health Starts Here Blueprint for Action: https://lnkd.in/guQunJ-W

Each year the Centers for Medicare and Medicaid Services (CMS) reviews payment practices and policy changes under fee-for-service, or traditional, Medicare. The CY2024 PFS included important coding and payment changes for services to address health-related social needs (HRSNs) through separate payments for Community Health Integration (CHI), SDOH Risk Assessment, and Principal Illness Navigation (PIN) services.

In July 2024, CMS released its annual draft proposed updates for next year’s rules (CY2025 Medicare Physician Fee Schedule), which includes a request for information (RFI) regarding barriers to implementation for services to address HRSNs. 

The draft rule also includes proposed updates to:

• Caregiver Training Services;
• ACO quality measures re: screening for HRSNs; and
• the Advanced Primary Care Model (APCM)

All of these proposed changes could affect services to address HRSNs. 

On September 9, 20204 the Partnership submitted two letters to CMS on behalf of Partnership Co-Chairs and undersigned organizations. Sixty-five organizations signed on to the response to the request for information (RFI) regarding current barriers to implementing services to address HRSNs (CHI/PIN). Fifty-three organizations signed on to the letter regarding changes needed and proposed updates for telehealth, caregiver training services, ACO quality measures, and the Advanced Primary Care Model. Agency officials will review and document the more than 12,000 comments submitted as they finalize the rule.

Stay tuned for updates once we see the final rule published—likely in early November 2024. We will also be in touch with stakeholders regarding implementation resources that we plan to create and promote
once we see the final rule.

The Partnership to Align Social Care and Camden Coalition hosted our eighth Coffee and Contracts session focused on compliance and risk management. Jennifer Raymond, Chief Strategy Officer at AgeSpan, and Mark Humowiecki, General Counsel & Senior Director of National Initiatives at Camden Coalition, shared their organizations' journeys with compliance and discussed what their compliance committees looks like, the policies and procedures in place, and how they meet healthcare standards. Participants broke into groups for facilitated discussions to learn from their peers about compliance and risk management.

Link to recording

Meeting Slides (PDF)

Resource: Compliance Checklist (excel sheet)

Meeting summary and notes (pending)

Each year the Centers for Medicare and Medicaid Services (CMS) reviews payment practices and policy changes under fee-for-service, or traditional, Medicare. The CY2024 PFS included important coding and payment changes for services to address health-related social needs (HRSNs) through separate payments for Community Health Integration (CHI), SDOH Risk Assessment, and Principal Illness Navigation (PIN) services.

In July 2024, CMS released its annual draft proposed updates for next year’s rules (CY2025 Medicare Physician Fee Schedule), which includes a request for information (RFI) regarding barriers to implementation for services to address HRSNs. 

The draft rule also includes proposed updates to:

• Caregiver Training Services;
• ACO quality measures re: screening for HRSNs; and
• the Advanced Primary Care Model (APCM)

All of these proposed changes could affect services to address HRSNs. 

SIGN-ON REQUEST:
Please consider joining the Partnership to Align Social Care Co-Chairs and other organizational stakeholders on TWO sign-on letters offering comments. You may sign on to one or both letters: 

1. Sign-on letter responding to the RFI re: barriers to implementing services to address HRSNs
2. Sign-on letter responding changes needed and proposed updates for telehealth, caregiver training services, ACO quality measures, and the Advanced Primary Care Model

We also encourage you to download template language covering all of these issues and incorporate as applicable into your organization's response . As a reminder, comments are due by 5:00 p.m. ET on September 9, 2024, and can be submitted online.  

RESOURCES:

• SIGN-ON Letters (combined) responding to CMS CY2025 PFS Proposed Rule (pdf)
• Template language provided by the Partnership (Word version available for download)
• CMS CY2025 PFS Proposed Rule: https://www.regulations.gov/document/CMS-2024-0256-0045 
• Additional information and resources from the Partnership about this proposed rule: https://www.partnership2asc.org/implementation-resources/ and Resources List

The Partnership to Align Social Care hosted a webinar, What Does the CY 2025 Medicare Physician Fee Schedule Proposed Rule Mean for Addressing HRSNs? on Tuesday, July 30.

Attendees heard an overview and discussion of these updates and learned about relevant CMS requests for information, and additional opportunities to inform the public comment process. CBOs and community care hubs, health plans, health systems, Federally Qualified and Rural Health Centers (FQHCs and RHCs), other healthcare providers, and caregiver advocate attendees learned about how the proposed coding and payment changes could impact efforts to align health and social care ecosystems.

This session focused on the intersection of data security, compliance, and quality improvement from a Community Care Hub perspective. Abigail Morgan, President & CEO of Direction Home Akron Canton Area Agency on Aging & Disabilities, discussed the milestones in her organization's journey to develop their data security infrastructure and shared lessons learned. Participants broke out into groups for facilitated discussions to learn from their peers about data security experiences and opportunities.

Link to recording

Meeting Slides (PDF)

Meeting Summary and Notes (PDF)

The session focused on data sharing experiences from health plan, CBO, and CCH partnerships. Jolene Tanner, Senior Director of Health and Social Programs at United Healthcare, and Amy Fynmore, Housing and Health Program Manager at United Health Group, provided an overview of various data sharing arrangements including through community investment and direct vendor relationships. Attendees also had the opportunity to break into moderated group discussions with their peers.

Link to Recording

Meeting Slides (PDF)

Meeting Summary and Notes (PDF)

This session focused on what to expect from negotiations with a health plan when developing a contracted partnership. Nikki Kmicinski, Executive Director at Western New York Integrated Care Collaborative, Inc., shared her experiences in negotiating with healthcare organizations and discussed strategies to achieve a mutually beneficial contract for both parties. Attendees also had the opportunity to break into moderated group discussions with their peers.

Link to Recording

Meeting slides (PDF)

Meeting Summary and Notes

This month’s Gravity Implementation Affinity Group featured Timothy McNeill, RN, MPH from the Partnership to discuss the new calendar year 2024 social needs HCPCS codes. Implementers learned how Gravity SNOMED-CT intervention codes align with and support additional documentation aligned with regulatory and policy drivers.

Thank you to Civitas Networks for Health for your support of the Gravity Implementation Affinity Group meetings.

Our Partnership to Align Social Care co-chair, Timothy McNeill, RN, MPH, spoke at USAging's Aging Policy Briefing with colleagues from around the nation about the 2024 Medicare Physician Fee Schedule and how to implement changes in billing codes to better align care between CBOs, health entities, and Area Agencies on Aging.

Tim was joined by Kelly Cronin, Deputy Administrator, Center for Innovation and Partnership, U.S. Administration for Community Living; Doug Jacobs, MD, MPH, Chief Transformation Officer, Center for Medicare & Medicaid Services; and Christine Vanlandingham, CEO, Region IV AAA in St. Joseph Michigan.

We encourage you to learn more about these changes in the Medicare Physician Fee Schedule here: https://go.cms.gov/4c5f090