Ready to Participate?

All that is required to participate is a signed Milestone ACO participant agreement.  For more information, please contact us.

 

Frequently Asked Questions

We frequently encounter the same general questions.  If the answer to your specific question is not found below, please contact us for more information.

 

How much will it cost me to Participate in Milestone Health's aco?

Participating in Milestone Health's ACO is absolutely free.

 

What are the benefits of Participating in an aco?

Here are just a few of benefits to participating Milestone Health's ACO.

(1) Bonus Payments

Get paid for the hard work you are already doing.  ACOs that are able to demonstrate savings share in these savings with CMS.  These savings are distributed to the you, the physicians who care for the patients, on an annual basis.

(2) PQRS Reporting

Do you participate in PQRS?  We can help.  If you participate in Milestone ACO, you will automatically get credit for your PQRS reporting when we report Milestone Health's ACO quality measures.

(3) Support Services

We provide care coordination support services in the form of care navigators, who are responsible for basic services to support the care you are already providing to patients, such as reminding them to receive preventive services, or help with chronic condition self management.  They also will also help prevent patient readmissions to the hospital by contacting patients after discharge to make sure they have any support services, such as home health or DME, and to make sure they have, and keep, their follow up appointment with you.

(3) Data

We provide you with the most complete information about your patient.  Log into our advanced data analytics platform and see which specialists your patients have recently visited.  Or, for new patients, view their prior claims history for the past year. We can also show you all diagnoses and care gaps for your patients, at a glance via our comprehensive, web-based platform.

 

What are the risks of Participating in an aco?

There is no financial risk to participating with Milestone Health ACO.  There is no obligation to the participants of Milestone Health's ACO, other than the obligation to agree to work towards the common goals of the ACO.

 

How Much can we expect to make if we participate?

While we can't guarantee that you will make money, we can give you some facts to take into consideration:

  • In 2014, ACOs qualified for shared savings payments of $460 million. (source)
  • In their first year, 11 ACOs in FL received an average of $416 per patient from CMS, or a total of $50.8M.

 

How long will it take before i get paid?

ACOs receive their share of any savings from CMS around Fall of the following year. For example:

2016 - Claims are billed for care provided to patients attributed to the ACO.

2017 - CMS determines any shared savings achieved in the prior year and distributes to the ACO their share of the savings in the Fall.

 

Won't this cut into my office billing revenue?

No.  Our focus for achieving shared savings is reducing wasteful services and preventing avoidable hospital admissions.  Here are the facts based on 1st year Florida ACO performance:

  • Successful ACOs had an average of 12,273 primary care office visits per 1,000 person years during the year, whereas ACOs that didn't achieve shared savings had fewer, with only 9,840 primary care office visits per 1,000 person years.
  • Inpatient costs for successful ACOs was approximately $300 less per patient than for ACOs that did not achieve shared savings.
  • ER spending was almost $250 less per patient for successful ACOs than for ACOs that did not achieve shared savings. 

 

In fact, by participating an ACO, you may see an increase in office visits.  Our care navigators will be ensuring that your patients are receiving appointments and receive preventive care and care for managing their chronic conditions.

 

This sounds like managed care.  Will you interfere with the care I provide to patients?

No.  Milestone Health's ACO is only there to support participants, and not to be involved in any day-to-day decisions you make about your patients' care.  Need more assurance?  Ask us to show you where to find this specifically written in our Participant Agreement.

 

What if I currently belong to another aco?

It depends.  Typically, contracts between ACO participants and the ACO are for three years, or shorter if you began participating with the ACO after their start date in the program with CMS.  You can request to leave an ACO and participate in another ACO, but it depends on your contractual obligations with the ACO in which you currently participate. 

 

What if I don't have an electronic health record?

Electronic Health Record use is encouraged, but not required, for participation in Milestone Health's ACO.

 

What is the deadline for participating in Milestone Health's aco?

As soon as possible!  We will continue to add participants during our three year contract with CMS. If you are interested in participating, we urge you not to wait.