A stethoscope and American money on a white background - HealthcAs of January 2016, there were 433 Medicare Shared Savings Program (MMSP) Accountable Care Organizations (ACOs) with almost 7.7 million assigned beneficiaries and more than 14,000 participants (a participant may be a group or an individual). Most of these ACOs are one-sided model ACOs that may generate shared savings and do not involve shared losses (Track 1 ACOs).

Importantly, Track 1 ACOs are not considered advanced alternative payment models (APMs) for purposes of MACRA. As a result, a clinician participating in a Track 1 ACO is subject to the merit-based incentive payment system (MIPS) just like a clinician that is not in an ACO (a participant in an advanced APM is not subject to MIPS).
Continue Reading Managing MACRA – Part V: What do I have to do if I’m in an ACO?

medicalequiptmentiStock_000013829082_LargeIn a 92-8 vote on April 14, 2015, the Senate passed a bipartisan measure to repeal the Medicare payment formula known as the Sustainable Growth Rate (“SGR”). The legislation also included a new payment system that rewards providers for the quality and efficiency of care they provide.
Continue Reading Value-based payments are heading for physicians

On July 10, 2012, two members of the Husch Blackwell Healthcare Group, Kate Mihalevich and Cori Turner, presented a webinar on ACO strategic physician alignment billing compliance.  The webinar:

  • highlighted compliance risks associated with ACOs and other physician alignment models; and
  • provided practical suggestions for evaluating and addressing risk in these areas.

To watch