POLICY & VALUE-BASED CARE · ACCOUNTABLE CARE ORGANIZATIONS APG’s Susan Dentzer on the Future of ACOs
Susan Dentzer, president and CEO of APG, America’s Physician Groups, shares her perspectives on where the development of accountable care organizations is headed, and where value-based contracting is headed more broadly, as she and her colleagues prepare By Mark Hagland
This interview was conducted by Mark Hagland before the “Transitions 2022: APG Colloquium” conference took place.
T
he APG, America’s Physician Groups, one of the leading national associations representing physician
groups involved in risk-based contract- ing, will be hosting its fall conference Oct. 31-Nov. 2 at the Grand Hyatt in Washington, D.C. Entitled “Transitions 2022: APG Colloquium,” the conference will bring together a roster of high-pow- ered healthcare policy leaders, as well as representatives of hundreds of APG member organizations. Among the speakers will be Anthony
Fauci, M.D., Director of the National Institute of Allergy and Infectious Diseases; Chris Jennings, former Chief Health Advisor to President Bill Clinton, and president of Jennings Policy Strategies; and Thomas Insel, M.D., author and executive director of Vanna Health. What’s more, on Tuesday, Nov. 1, Susan Dentzer, APG’s president and CEO, will moderate a panel entitled “The Bumpy, Slow, and Circuitous Route to Value-Based Healthcare,” and whose panelists will be Adam Boehler, former Director of the Center for Medicare and Medicaid Innovation (CMMI); Patrick Conway, M.D., former Director, CMMI; Seema Verma, former Administrator of the Centers for Medicare & Medicaid Services (CMS); and Gail Wilensky, Ph.D., former director of the Health Care Financing Administration (now CMS). In addition, the various tracks will offer sessions that focus on the integration of primary and specialty care; creating, scaling, and sustaining behavioral health integration in primary care; integrating value-based oncology into primary care;
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innovations in care delivery; the future of advanced care at home; pharmacy in team-based care; caring for homeless older adults in value-based arrange- ments; geriatric and urgent care in the home; healthcare workforce recruitment and retention; and policy developments at the federal and state levels. Healthcare Innovation Editor-in-
Chief Mark Hagland spoke recently with Susan Dentzer about the program and more broadly about where value- based care contracting and accountable care organization (ACO) development are, right now. Below are excerpts from their interview.
Tell me about the conference? We do a spring conference in San Diego and a fall conference in DC. We’re calling this “Transitions 2022,” to capture the fact that we’re in a bunch of transitions, includ- ing with regard to the upcoming elections, at the national and state levels, as well as the ongoing transition to value and transi- tions in terms of the delivery system, as well as who’s who and who’s doing what in healthcare. And we’ve just had several major acquisition announcements in the last few months, with new and new-ish players coming into healthcare. And also, transitions underway for APG. For sometime within APG, we’ve had
groups oriented around particular aspects of payment and delivery reform. We’ve had our ACO Reach Coalition; and we had something called the Risk Evolution Task Force, which we’ve renamed our ACO MSSP Coalition, focused on MSSP, particularly in light of the fact that, in the most recent physician fee schedule announcement, CMS indicated they’re going to make a lot of changes in the MSSP, to keep that program alive and keep the number of entrants a robust number; but they’ve also announced that they’ll create advanced incentive payments, to lure smaller practices into MSSP; and they also intend to inject some
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hcinnovationgroup.com | NOVEMBER/DECEMBER 2022
equity features into the MSSP. That could bring new members into APG, to join our experienced members. And we have a joint meeting on October
31 of those two coalitions, and Liz Fowler will be addressing both of those. And before that, we have a lunch for our Clinical Quality Leadership Forum, our physicians who have been extremely highly focused on quality in their organizations. And Lee Fleischer, M.D., the head of the Center for Clinical Standards and Quality. The entity within CMS that focuses on quality; and Dr. Fleischer will speak to us. So, we have our joint session with Liz Fowler, and then the coalitions are going to split up and meet separately, and the ACO MSSP Coalition will meet separately, as will the ACO Reach Coalition. Purva Rawal works under Liz at CMMI, and will be speaking to that coalition.
I’d like to ask you your perspective on a situation that evolved forward during 2019 and 2020, involving the previous administration, and tension between CMS under Seema Verma and some of the provider associations, around how the Medicare Shared Savings Program (MSSP) was architected, particularly around benchmarks, as well as the timing of certain elements. Seema Verma was pressuring provider organizations to take on downside risk as fast as possible, and provider associations were pushing back, warning that huge numbers of providers might leave the MSSP. That tension between federal health authorities and providers seems to have eased somewhat in the past year-and- a-half—would you agree? Yes; it’s eased because the policy’s changed, the administration’s changed, and the approach has changed. If you
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