Doctors Will Now Know if Medicare Beneficiaries Belong to an ACO

The problem with treating Medicare beneficiaries who are ACO members, as many physicians see it, is that those patients are not identified until the end of the year. “Despite ACOs garnering $466 million in Medicare program savings in 2015, many providers are still wary of the amount of risk the payment models require them to take on,” Modern Healthcare reports. “Those concerns are amplified by not knowing which patients they would be evaluated for.”

CMS has heard those complaints and has moved to ensure that doctors know from the beginning which of their Medicare patients belong to ACOs. Currently, 480 ACOs serve about 9 million Medicare patients.

ACOs include all the providers who will serve patients, including specialists and technicians. CMS’ Medicare website has been updated so that beneficiaries can list their primary care physicians and if those physicians are affiliated with an ACO, it discloses that information as well. The beneficiary will be assigned to the PCP and the ACO that the PCP is affiliated with. The PCP will be taking on the risk within the ACO confines.

Source: Modern Healthcare