By joining PrimeCare Managers ACO, independent primary care practices will have an added advantage to flourish in the future, as health care payment evolves to a platform of volume and value. Our healthcare world view recognizes the power of primary care, aligned directly with payers such as Medicare and direct-to-employer relationships.
PCM manages all aspects of an Accountable Care Organization.
Handles the forming and application process with CMS
Works with CMS to provide continuous, on-site practice transformation and support for doctors, nurses, and practice staff
Ensures all partner physicians meet necessary ACO, meaningful use, and EHR and quality reporting requirements
Provides customized technology to optimize existing EHRs and patient claims data
Creates software, platforms, and applications to assist with patient outreach, engagement, and treatment
Helps doctors build high-value referral networks
Identifies at-risk patients
Coordinates admission, discharge, and transfer status of patients
The Department of Health and Human Services announced in 2014 that Medicare will shift 50 percent of Medicare reimbursements towards alternative payment models like ACOs by 2018. Medicare Advantage payers are following by also shifting to value-based payments. In January 2015, the sustainable growth rate, or “SGR,” was replaced by Congress, which voted to give doctors a 5 percent bonus for participating in alternative Medicare payment systems like ACOs.
An ACO is a new regulatory model which empowers primary care physicians to drive, define and capture the value they create for the health care system through enhanced patient access, identification of at-risk patients, care coordination, chronic disease management, prevention, and care team interventions to fill gaps in care. In an ACO, primary care physicians continue to receive payments for their services; plus, you get additional revenue by sharing any savings from fewer avoidable emergency room visits, hospitalizations, and unnecessary and potentially harmful procedures.
PCM’s ACO empowers primary care physicians to remain independent, gain insight into their patients’ care, and share in the savings generated by their ACO. Doctors who work with PCM keep their independence — you are our partners. We are not consultants. We are not affiliated with any hospital or health system. Our interests are 100 percent aligned with our partner doctors; we succeed only when we help our practices generate shared savings.
If you have difficulty understanding our work process. Please contact us for better information.
Are you a Registered Nurse with long-term care experience looking for a change of pace?
Seeking an individual to join our team as VP of Operations for value-based accountable care organization.
Reviewing of medical records to determine diagnoses coding, and referral information meets the accountable care standards.
Texas licensed nurse practitioner to provide chronic risk assessments and care team follow-up for senior populations.
Insurance companies are now transformatively close to calling their members, their patients. Do you see the vision for a better partnership recipe? CMS is funding the PCP ambition with new revenue which puts the PCP directly in charge of community lead care across the country.
THE QUESTION IS: With what speed will change be made, and who will drive the continuance of the ‘value’ initiative?
ACOs achieved an overall decrease in expenditures compared to expected benchmark expenditures.
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