From eligibility and guidelines to strategies and payment, know everything you need to guarantee success in a risk-based Shared Savings Program.
Just base it on your historical claims data. Look into your historical PMPM, utilization, and risk scores for the population. And structure your network to produce the best outcomes.
You can move into the new Shared Savings Program by analyzing how well each provider delivers care. Do that and you can easily identify which practices would thrive, and which ones wouldn’t, then structure your teams accordingly.
Look into your prospective savings based on previous claims. And get the top three ways of structuring Medicare lives into different tracks.
You can also look into patient loyalty and attribution. Based on an analysis of eligibility files, providers can discover which PCP or practice in the network delivers efficient care and displays high patient loyalty, and plan patient attribution.
With over 3,500 physicians across 196+ locations, this Iowa ACO leveraged powerful actuarial analytics and consultation from leading healthcare experts to participate in a risk-based track and generate successful outcomes.
MSSP ACOs have been around for almost 6 years now, and have reduced healthcare spending by over $1 billion.
Before filing an application, the participating physicians group together and register their network as a legal entity. Easy, so far. Then the participating organizations should assess their capabilities and educate their providers on the details of the framework.
In order to submit an application, ACOs must first submit a Notice of Intent to Apply (NOIA) for any of the applications referenced above. ACOs must submit an NOIA to be eligible to submit an application(s) for the year’s program start date; however, an NOIA submission does not bind an organization to submit an application.
Once the agreement has been signed and the organization has officially been listed as an ACO, the ACO needs to be operationalized. What does that mean? The ACO must have a website, publish publicly reported information, and have an action plan to coordinate care, promote evidence-based medicine, and distribute shared savings among the providers.
Check the boxes off as you form an ACO complying with all the legal and operational requirements of CMS and advocate accountable care.
Learn all the technical requirements of becoming an ACO and lead your patients to a data-driven healthcare oriented around quality.
What you need to do:
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