Monday, November 27, 2017

ACHCA Announces Bill McGinley, CNHA, CALA, CAS, FACHCA as New President and CEO

We are excited that our very own Bill McGinley is the new President and CEO of ACHCA!

Bill is a member of the Assisted Living Administration Advisory Committee for Saint Joseph’s College of Maine!.  

The American College of Health Care Administrators (ACHCA) has selected Bill McGinley, CNHA, CALA, CAS, FACHCA as its new President and CEO effective December 4, 2017. Mr. McGinley has been in the field of long-term care administration since 1980. His leadership skills and knowledge will greater strengthen ACHCA’s future. He has been a Nursing Home Administrator for 35 years. He began his career with the Greenery Rehabilitation Group, Inc. a nationally known leader in the field of head-injury rehabilitation and sub-acute care. The majority of Bill's career was with SALMON Health and Retirement, a Massachusetts family owned company managing a SNF, ALR, Adult Day Health Center, and a child care center. Most recently he was the executive director of New Pond Village, a CCRC in Walpole, MA.

Bill holds an MBA from Boston University with a concentration in Health Care Management. He is a Fellow of the America College of Health Care Administrators (FACHCA). He is also a Certified Nursing Home Administrator (CNHA), Certified Administrator of Sub-Acute Care (CAS), and a Certified Assisted Living Administrator (CALA). He is certified as an assisted living director (CDAL) by the Senior Living Certification Commission. Bill recently became only the third person in the country to achieve the Health Services Executive (HSE) credential from the National Association of Long Term Care Administrator Boards (NAB).

In May of 2010 he was named Outstanding Member of the American College of Health Care Administrators (ACHCA). In 2017 ACHCA named him as the recipient of the Distinguished Assisted Living Administrator Award.

Bill is the past President of the Massachusetts Chapter of the American College of Health Care Administrators. He was the chair of the 2009 Convocation in Providence, RI. He was the chair of the ACHCA Professional Certification Committee and served as an item writer for the certification exams. He was a founding trustee of the MetroWest Health Care Foundation and served as chair of the MetroWest Healthcare Foundation Commission on Healthy Aging. 

Monday, November 13, 2017

Next Generation Accountable Care Organization (NGACOs)

The NGACO Model offers Accountable Care Organizations (ACOs) the option to participate in a payment model called All-Inclusive Population Based Payment (AIPBP) where the ACO will take the responsibility for entering into payment arrangement with their providers and paying claims instead of Medicare paying it through the Fee-for-Service (FFS) program.

The goal here is to establish a monthly cash flow for the AIPBP participating ACOs through a mechanism called the Next Generation Participants and Preferred Providers. The plan is that the AIPBP builds on population based payments in the NGACO Model but actually allows for more flexibility in establishing payment relationships between the ACO and their providers.

So to establish a monthly cash flow, under the AIPBP a participating ACO can receive a monthly lump-sum payment for those providers that have entered into a written agreement for AIPBP Payment Arrangements. The monthly payment will be based on an estimation of the care that the provider will deliver to the beneficiary in the performance year by AIPBP participating providers. These lump-sum payments will be reconciled after the performance year so they can balance out the monthly payments against what AIPBP participating providers would have received under the Fee-for-Services program.

Providers will continue to submit Fee-for-Service claims to Medicare, but payments will not be made on these submissions to providers that signed-up to participate AIPBP (outside of add-on payments for inpatient hospitals (outlier, disproportionate share, IME, new technology and Islet isolation cell transplantation payments). If a provider does not have an AIPBP Payment Arrangement in place with an ACO, they will continue to receive Fee-for-Service payments for all of the patients/beneficiaries they treat.

Providers will continue to submit all Fee-for-Service claims to CMS and CMS will make coverage and liability determinations and assess beneficiary liability. Beneficiary liabilities will be calculated based on what Medicare would have paid the provider if they were not involved with an AIPBP. Medicare Summary Notices (MSN) should reflect the amount that would have potentially been paid. Providers in the AIPBP will continue to receive MSNs.

For more information on this topic, feel free to visit https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE17011.pdf

Provided by Kevin Harrington, MATS, MSHA, RHIA, CHP  Faculty, Saint Joseph's College