Physician Practice

ACO benefits outweigh drawbacks

Physician Practice Insider, December 1, 2015

Some physicians and physician groups are still wary of joining an ACO, but as the industry continues to transition from fee-for-service to value-based care, more practices may find themselves integrating into some type of ACO or ACO-related program. The question of whether a practice should join an ACO depends on a number of factors. They include the area of care management the ACO is focused on, the financial incentives involved, and how much control a practice will have in its collaboration with payers and other participants.

Teresa Koenig, MD, senior vice president and chief medical officer for Los Angeles–based The Camden Group, says that joining an ACO may not be a bad idea for any practice as the medical industry continues to transition away from the traditional fee-for-service world.

“The pace of change has accelerated very rapidly in the past few years and quickened much faster than most people predicted,” says Koenig. “There are very few markets left that are based on ‘if’ as opposed to ‘when.’ ”

Shared savings plans an entry point
Koenig says that for many practices, starting out in a Medicare Shared Savings Program (MSSP) is a preferred entry point in the world of ACOs and alternate payment models.

“With MSSP, there are few risks because the big buckets of costs in the programs are handled by hospitals and other providers, instead of the physicians,” says Koenig. “For physicians, the focus is on getting the patient to the right site for care.”

Jennie Hitchcock, CCS-P, CMPE, a practice management and compliance consultant with DoctorsManagement LLC in Knoxville, Tennessee, agrees that MSSPs are a low-risk entry point for physician practices interested in testing the waters.

“Joining an ACO, particularly an ACO that is restricted to the Medicare Shared Savings Program, may enable a practice to share in savings that they’re helping to generate,” says Hitchcock. “The program attributes patients to an ACO based on the physician that has treated them most frequently during the prior period.”

This article was originally published in Physician Practice Perspectives.

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