PHYSICIANS

Gains for Your Medicare Patients in LTC Facilities Finally Means Gains for You!

Participation in LTC ACO presents a new opportunity to participate in a model that works towards achieving better healthcare and quality outcomes for long-term care residents and incremental revenue opportunities for providers. In the event quality and participation outcomes are met, participating physicians will share in the savings attributed by CMS to the ACO. View our key benefits listed below.

25% Shared Savings Opportunity with NO Downside Risk
Participation in the LTC ACO entitles physicians to earn 25% of the savings generated based on your specific patient population (assuming the ACO in total produces shared savings). In case there are no savings, physicians face no financial risk whatsoever.
5% Bonus for ALL Primary Care Physician-based
Medicare Fee-for-Service Billings
LTC ACO qualifies as an Advanced Alternative Payment Model (AAPM) under Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Therefore, LTC ACO participating physicians are eligible to receive a 5% bonus for ALL primary care physician-based Medicare fee-for-service billings, including LTC ACO attributed patients AND all other Medicare fee-for-service patients seen by the physician.
Elimination of Complex MIPS Reporting Requirement & Penalty
Participation in LTC ACO and AAPM eliminates the administratively burdensome MIPS reporting requirements and allows physicians to focus more of their time on patient care. Providers that aren’t participating in an AAPM may be subject to a penalty on traditional Medicare revenue beginning in 2020. Since LTC ACO qualifies as an AAPM, physicians actively participating in LTC ACO will avoid this penalty.
Get the Full Picture of Your LTC Patients' Health with Access to All of Their Medicare Claims Data
Today, you only have access to the Medicare-covered services you provide to your LTC Medicare fee-for-service patients.  By participating in LTC ACO, you will have access to Medicare claims data for all Original Medicare services provided to your LTC ACO patients, including those services delivered by other providers outside of the LTC facility. The ACO will provide reports to you to help you interpret the quality and cost of care provided to your patient, so that we can find ways to improve outcomes together.

Note: Medicare Beneficiaries may elect to opt out of data sharing.

Want to Learn More About Participation with LTC ACO?