Transcript Generated by AI 00:01 Mark Parkinson back with Park Place and a really important interview today to talk 00:06 about value-based care and specifically the new LEAD program. 00:10 And I think most of you are aware that Provider Partners is our thought partner 00:14 on Park Place on all of these topics. 00:17 And we're very fortunate to have Eric Palm, 00:19 who's the Chief Growth Officer from Provider Partners back with us. 00:23 You might recall on an earlier video, Eric had predicted that the ACO programs 00:28 would continue. 00:29 There was a lot of talk about with REACH sun setting, would all of this continue 00:34 or not. 00:35 Eric said that it would and it turned out that he was right. 00:38 And so we're here today to talk with Eric about what the new program is. 00:40 So, Eric, welcome back to Park Place. 00:43 Thanks, Mark. 00:44 Appreciate the time. And congrats on being right. 00:47 The end of of REACH did not mean the end of the ACO world. 00:51 And and you were at, you were right about that. 00:53 Yeah. 00:54 Yeah. 00:55 I think a blind squirrel finds a nut every so often. 00:58 I think they say. Well, I think you're being modest. 01:01 And it's not just that the ACO world has continued with the new LEAD program. 01:06 The exciting news is that the LEAD program is actually better than REACH. 01:11 So tell us what the features are the LEAD program that make it better than REACH? 01:17 Yeah. 01:17 And we're learning more and more on the methodologies of LEAD for 2027 along the 01:22 way. 01:23 I think there's a couple of really exciting evolutions in the ACO space. 01:28 I think the first one really is that from an ACO perspective, 01:32 high needs REACH was just that high needs medically complex population. 01:36 But now with the onslaught of lead, it is really rolled out to anyone that 01:41 has traditional Medicare that lives and resides in long term care really in your 01:45 facility. 01:46 So now we're probably going to double the population because because now it's just 01:51 not the high needs. 01:52 It is those relatively healthier population that leave lives in your 01:56 building. 01:57 And then the other big change is now that LEAD is a 10 year CMMI project. 02:02 There's no changes in how they're calculating that the benchmarks long term. 02:06 So while ACOs were performed year over year and make a lot of money, 02:10 CMS would come in and recalculate year over year to make it a little bit harder 02:15 on you. 02:16 And now as an ACO, they basically have given us a 10 year 02:20 runway on that particular subject. 02:22 So it's great that they're not recalculating and re changing these 02:25 benchmarks and how they're going to calculate them long term. 02:30 One of the other big enhancements is that the idea of a concurrent benchmark. 02:34 So in their LEAD ACO, they are going to give concurrent 02:37 benchmarks along the way. 02:38 So as your residents get more sick, your risk scoring your benchmarks 02:42 ultimately increase over time. 02:44 I mean that that's all really good news. 02:46 I mean, first of all, we now have a 10 year program, 02:48 so we don't have to worry about the, you know, how long this lasts. 02:51 I think it's really exciting that it applies to every single long term care 02:55 resident that's Medicare eligible. 02:57 So as you indicate, that's like double S the population and 03:01 it just makes the returns on the shared savings so much more predictable. 03:05 All obviously great news. 03:07 I know there's a lot of other nuance improvements in the program and all of 03:11 that is exciting. 03:13 Now there are all these dates that keep getting publicized and all the trade 03:16 press about when you have to do this, that or the other to be eligible. 03:20 And if you look at some of the trade press, 03:22 it feels like some of those dates have already passed. 03:25 Is it too late for providers to be involved in 2027 in ACO programs? 03:31 Yeah, So there was a big deadline that just 03:34 passed of August 5th to submit providers, meaning practitioners tins to CMS for 03:40 alignment purposes. 03:42 There are multiple strategies and how to align long term, 03:46 whether it's using a TIN or an alternative TIN. 03:49 But I guess the basis of it is there's you haven't missed the deadline. 03:54 There was a, there was an August 5th deadline, 03:56 but CMS also create a second deadline of January 14th. 03:59 And so there's those two inherent deadlines. 04:03 But then also long term there's strategies to participate in AC OS kind 04:08 of mid year we should say. 04:10 So no, we haven't missed any deadlines at all. 04:13 Yeah. 04:13 And I mean, all this is a very exciting because as 04:16 we've talked about before, what all of this is about is it's about 04:20 providers getting paid to keep people well and sharing some of the savings that 04:25 historically we've just been giving to the either the government or to a managed 04:29 care insurance program. 04:31 So it's just terrific, Eric. 04:34 It's also complicated. 04:36 There's a lot of different companies around. 04:37 There's a lot of different products around. 04:39 If a provider wants to participate in this, what should they do it? 04:43 It ultimately is is starting with some baseline education on AC OS. 04:48 It's the alphabet soup of value based care. 04:50 It is unbelievably complex, but really get an understanding of the 04:54 different models, but then understanding who's in your 04:57 building participating in these different models. 05:00 Today we see it all the time that a, that a nursing home operator comes in and 05:05 doesn't realize that there's a model happening and they want to participate. 05:09 They want to enhance clinically what they're doing for their residents that 05:13 they take care of and want to participate in these models. 05:17 And so, you know, our mission and vision long term is to 05:20 help incorporate the operators into into the value based care space. 05:25 Because the reality is even people that say out, 05:27 I don't have the time to mess around with this or it's too complicated. 05:31 There may be AC OS in their buildings where doctors are already getting shared 05:35 savings and they're not participating, that the providers aren't participating. 05:40 You can help them figure that out, correct. 05:42 Absolutely. 05:43 Happens all the time. 05:44 Yeah. 05:45 Well, Eric, I know you guys, provider partners is that, 05:48 you know a ton of upcoming conferences, I'm sure you'll be at the ACA conference 05:52 and many others. 05:53 And I would just encourage our viewers who are trying to navigate this very 05:57 complicated space to reach out to Eric and to provide our partners and really 06:02 figure out what your strategy is, because this is this is what the future 06:06 is all about. 06:07 It's not just doing it for that reason, though. 06:09 It's because it's also great care. 06:11 It's us getting compensated for providing great care. 06:14 Eric, thanks for your continued support of, 06:16 of Park Place and good luck with the, the, the new ACO program. 06:20 Thanks Park, and thank all of you for your continued 06:23 support of Park Place.
