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.

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.

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.