What is an ACO?
A group of Medicare providers and suppliers that will work together to coordinate care for the Medicare Fee-For-Service patients they serve. The goal is to deliver seamless, high-quality care for Medicare beneficiaries, instead of the fragmented care.
P3N ACO is participating in ACO Track 1 of Medicare Shared Saving Program.
- Minimum of 5,000 Medicare Fee for Service patients.
- No downside risk for participants.
- Savings Rate: minimum 2.0% up to 3.9% maximum depending on the number of assigned beneficiaries.
- Shared Saving Rate: up to 50% based on quality performance.
For general questions or additional information about Accountable Care Organizations, please visit www.medicare.gov/acos.html or call 1-800 MEDICARE (1-800-633-4227).
TTY users should call 1-877-486-2048
How will we achieve savings?
Hospitalist Program linked with our case manager to manage length of stays and transition of care with our TCM program. Repatriates your patient back into your practice (assisted by our partner Companion Home Health).
Chronic Care Coordination
Chronic Care Coordination linking our AWV, TCM and CCM programs together with CMS claims data and our clinical operations team to identify and manage high risk and disabled patient population (assisted by our partner ADVANTMED).
Frequently Asked Questions
What is an ACO?
- Our Accountable Care Organization (ACO) is a group of doctors who come together voluntarily to coordinate high quality care for their Medicare patients.
- When an ACO succeeds both in delivering high-quality care and spending health care dollars more wisely, the ACO and its member share in the savings achieved for the Medicare program.
What is the Medicare Shared Savings program?
This program (MSSP) puts physicians in control of spending for each Medicare patient for which they are serving as the primary care physician. If there are savings at the end of one year over the patient’s prior three year cost average, the physician will share them with the government.
Is there a downside to the program?
We have elected to participate in Medicare Shared Savings Track 1. There is no financial risk to the physician.
What are the benefits of joining the program?
- Our ACO is lead by our physician members.
- We help you earn the highest MSSP savings bonus possible.
- Participating in the ACO will optimize your MACRA/MIPS reporting and avert the escalating 4%-9% reductions in your CMS payments.
- We offer additional Value Based Reimbursement programs that complement the ACO including: Annual Wellness Visit (AWV), Chronic Care Management (CCM), and Transitional Care Management (TCM).
- We create the “glue” to help you stay independent, but backed by the power of physicians standing together.
What do I have to do?
Keep treating patients and practice quality medicine. Since you will share in any savings, you are incentivized to control costs, which mean addressing care needs proactively to reduce hospitalizations and poor outcomes. Your focus remains on the patient and his/her health and wellness. We help your practice with this.
What if I am a specialist?
If you have Medicare patients whom you serve as a primary care physician you are eligible to participate in the Medicare Shared Savings Program.
Do I give my Medicare patients to the ACO?
No. You retain your patient relationships and only designate them as covered by the ACO. In fact, with the P3N ACO designation you clarify to Medicare and others that these are your patients, which helps to avoid the co-opting of patients we are experiencing by other entities.
Can I sign up with more than one ACO?
No. Your Tax Identification number (TIN) may only be associated with one ACO.
How can I check if my TIN is being used for another ACO?
By signing up with P3N’s ACO we will help you check your status.
How do I switch ACO’s?
It is within your rights to terminate your current ACO Participant Agreement. We will gladly assist you in ensuring this process is as streamlined as possible and completed before the July 31st deadline. You will need to notify the ACO you are with via certified mail to remove your TIN immediately through the HPMS (Health Plan Management System) on the CMS website. It is imperative that you begin the disenrollment process as soon as possible to ensure your TIN is removed in time to enroll in our ACO before the anticipated enrollment deadline on July 31st, 2017 (final participation adjudication will continue until August 29th).
How long am I committing to?
We encourage you to participate over the full three years of the program to optimize your benefit. You may opt out at any time.
How can I enroll in the program?
Sign a participation agreement with our P3N ACO.