AMA considers advocating that CCRCs be part of ACOs

Share this content:
The three AMDA resolutions were presented by Eric Tangalos, MD, CMD, and Rajeev Kumar, MD, CMD, a delegate and alternate delegate, respectively, to the AMA House of Delegates, according to AMDA.
The three AMDA resolutions were presented by Eric Tangalos, MD, CMD, and Rajeev Kumar, MD, CMD, a delegate and alternate delegate, respectively, to the AMA House of Delegates, according to AMDA.

The American Medical Association will lobby the Centers for Medicare & Medicaid Services to allow continuing care retirement communities to initiate investment models of accountable care organizations if its board of trustees approves a resolution that the AMA's House of Delegates referred for a decision last week at the delegates' meeting in Chicago.

In addition to CCRCs (also known as life plan communities), the AMA resolution includes other long-term care facilities and physicians who work in such settings.

Under the ACO Investment Model, designed for ACOs that are part of the Medicare Shared Savings Program, according to CMS, pre-paid shared savings are used to encourage new ACOs in rural and underserved areas and to encourage current Shared Savings Program ACOs to transition to arrangements with greater financial risk.

House of Delegates members' reaction to the resolution, which AMDA–The Society for Post-Acute and Long-Term Care Medicine said was proposed by AMDA members, were “mixed,” according to an account of the body's meeting posted on the AMA website.

“Numerous speakers raised concerns that the action called for in the resolution may result in the potential for abuse and that more information is needed on this issue,” according to the account. Such advocacy could “increase the availability of alternative payment models available to physicians,” said members of the committee that recommended that the House of Delegates refer the issue to the board to decide, although they said that the issue warranted more analysis by the board.

AMDA's own House of Delegates, at the organization's annual conference earlier this year, had passed a resolution calling for AMDA to work with the AMA as well as LeadingAge, the American Health Care Association and other interested parties to enable CCRCs and other long-term care facilities to participate in the ACO Investment Model.

“Long-term care and continuing care retirement centers are ideal candidates for patient-centered medical homes and ACOs due to the congregate living arrangement for frail elderly residents and the presence of medical directors and practitioners on site,” the AMDA-passed resolution stated, “but they lack the financial wherewithal to successfully create and implement such programs.”

The prepayment of shared savings under the ACO Investment Model, according to AMDA, alleviates the financial burden of creating new ACOs. “Any such financial support from the federal government in the form of advance payment of shared savings is impactful in allowing LTC, CCRC and practitioners in such settings to successfully implement electronic health records and data analytics programs that are essential for participation in population health programs,” the AMDA-passed resolution stated.

Medicaid, pressure ulcers and SNFs

The AMA House of Delegates also voted to adopt a policy that the association oppose caps on federal Medicaid funding. The board may take additional action after studying an internal report on mechanisms for Medicaid funding.

AMA delegates also passed a resolution, proposed by AMDA members, that the AMA formally oppose a change in the nomenclature from “pressure ulcer” to “pressure injury” in the ICD-10 and other diagnostic catalogues and classification systems. Committee members were concerned that the term “injury” could have legal ramifications.

AMDA also members proposed a resolution to advocate for the removal of three-star minimum requirements for skilled nursing facilities to participate in next-generation ACOs and bundled payments for care improvement programs and care for patients with waiver of the three-night hospital stay requirement. That resolution, as was the CCRC/ACO one, was referred to the AMA board for a decision.

The three AMDA resolutions were presented by Eric Tangalos, MD, CMD, and Rajeev Kumar, MD, CMD, a delegate and alternate delegate, respectively, to the AMA House of Delegates, according to AMDA.

close

Next Article in News

Sign up for newsletters

In Focus

June 21

A flash mob to remember

Indianapolis

Indianapolis International Airport visitors recently were surprised by a flash mob organized by American Senior Communities to raise awareness and funds for the Alzheimer's Association during June, which is Alzheimer's and Brain Awareness Month.