Consider This Before Joining an ACO – Review of Ophthalmology

Patients and providers can both benefit under a Shared Savings Program alternative to the standard fee-for-service practice.

This article answers the following questions:

• What drives the Centers for Medicare & Medicaid Services to consider alternatives to paying providers under the current Medicare system?
• Are Accountable Care Organizations one such alternative payment system?
• Are Shared Savings Program concepts aligned with the Affordable Care Act?
• Will this Shared Savings Program save CMS dollars?
• Is an ACO just another kind of health maintenance organization?
• How are Accountable Care Organizations structured?
• Do different ACO models exist?
• Will participating providers face reduced reimbursements on their claims if they join an ACO?
• What motivates a provider to join an ACO if reimbursement rates are the same as their MPFS rates?
• How will quality of care be measured?
• What if an ACO doesn’t meet performance and savings benefits?
• Must providers participate in an ACO?
• Has CMS released any information about the money saved by ACOs?
• Are patients required to join an ACO?
• May ophthalmologists and optometrists join more than one ACO?

This article was published in Review of Ophthalmology’s Medicare Q & A column, which is written by Corcoran’s Vice-President, Donna McCune, CCS-P, COE, CPMA. To view the entire article in Review of Ophthalmology, click on the link below:

http://www.revophth.com/content/d/medicare_q___and___a/i/2882/c/48968/