Don’t Let Misunderstandings about ACOs Hold You Back from Value-Based Care Success 

There is no better time to join an ACO than right now, but providers must cut through a lot of noise to get to the truth about the benefits of being in an ACO. Caravan Health knows ACOs better than anyone – we have worked with hundreds of health care providers as they implement value-based care to save money and improve care quality.  

Don’t get left behind – learn the truth about ACO misconceptions: 

Misconception #1: ACOs require us to take unacceptable levels of risk

The reality is that every Medicare provider will have to take on risk or lose out on income in the next few years. An ACO is one of the safest ways to get into risk. Caravan Health can get any health provider ready to take on risk within two to three years. We are so confident in our model that we will take on 75 percent of any downside risk. We don’t think either of us will end up writing a check.  

Misconception #2: Reduced billing will hurt my bottom line

It’s simply not true that ACOs reduce income from inpatient hospitalizations – MedPAC backs us up on that. In the 90’s, aggressive HMO tactics dramatically reduced hospitalizations, and there is little room for more cuts in that area. ACO savings come from other places, like reduced post-acute care expenses.  

Misconception #3: My practice can’t win under the new rules for the Shared Savings Program

The new Pathways to Success Program has some real benefits to go along with the faster path to risk. ACOs will get a more money for treating patients with more serious health conditions. Providers will also have a regional adjustment to their benchmark in the first agreement period—a change that ACO advocates have long wanted.  

Misconception #4: I can’t gamble on joining an ACO with other independent providers

Smaller community providers take a bigger gamble by not jumping into value-based payment. In a Caravan Health ACO, we have a proven governance model that keeps all practices accountable to each other – and produces industry high quality and savings results. What’s more, our larger collaborative ACOs take advantage of scale. Just like health insurance companies, ACOs need to spread risk out across more covered lives to manage swings in health care costs. An ACO should be large – at least 100,000 attributed lives – to see consistent and reliable results.  

Misconception #5: My Medicare spending per patient is already low, I can’t get it any lower

Even providers with low benchmarks can succeed in an ACO. The newly finalized rules for Pathways to Success take regional benchmarking into account earlier in the process, and still in a very evenhanded way. ACOs with low costs compared with their regional averages are recognized and compensated in the formula.  
 

Clearing up these misconceptions make it clear that ACO success is within reach. Caravan Health knows that any provider can get ready for risk under Pathways to Success within two to three years. Caravan’s proven ACO model has helped hundreds of hospitals overcome barriers to achieve population health success.  

Learn more at our webinar

 

Recent Articles and News

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Managing the COVID-19 Crisis: Stop the Risk Clock for ACOs

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COVID-19: A Summary of Emergency Government Funding and Medicare Telehealth Options

In response to the fast-moving global health emergency caused by COVID-19, Congress has approved $8.3 billion in emergency supplemental funding. The aid will help federal agencies prepare to manage and contain the spread of this highly contagious respiratory illness. In addition to providing funds for preparedness and response activities, the new law makes it easier for Medicare providers to evaluate their patients remotely during this national health emergency.

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