Eligible for: ACMPE: 1|ACHE: 1|CEU: 1|CME(AAPC*): 1|CPE: 1.2|PDC: 1|PDU: 1 *MGMA is now offering our full conference for AAPC credit via our partnership with ACCME. Please see the event Continuing Education page for more information. Traditional | Basic | Comprehension
*Session will be included in the MGMA Summit.
State and federal payers are designing new incentive models to shift current healthcare reimbursement away from fee-for-service (FFS) and toward value-based payment structures. Accountable care organizations (ACOs) are a popular method of moving to value. The latest ACO REACH (Realizing Equity, Access, & Community Health) model utilizes a shared savings/risk structure to incentivize participants that can improve quality outcomes while reducing unnecessary costs. The model offers customizable options for building arrangements that encourage innovation and expand participation to a wider variety of applicants. Each ACO REACH applicant must select a payment mechanism, risk level, and alignment type; but some had challenges understanding which options would best complement their organization's needs. This session will detail developing ACO applications and conducting analytics to identify a provider’s best ACO path, as well as the tools needed to evaluate ACO target budgets for potential savings/deficit scenarios and financial impacts of replacing their Medicare FFS revenue with monthly capitation payments.
Learning Objectives:
Explain the concept of risk sharing and how it applies to ACOs and VBP arrangements.
Recognize readiness for applying to become an ACO or entering VBP arrangements.
Identify the key components of successful ACO performance and VBP performance.
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