A Primer on Accountable Care Organizations Raymund C. King, MD, JD, FICS Law Offices of Raymund C. King, MD, JD, PLLC Plano, Texas TASCS 2013 Annual Meeting.

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Presentation transcript:

A Primer on Accountable Care Organizations Raymund C. King, MD, JD, FICS Law Offices of Raymund C. King, MD, JD, PLLC Plano, Texas TASCS 2013 Annual Meeting – Houston, TX November 8, 2013 Raymund C. King, MD, JD, FICS Law Offices of Raymund C. King, MD, JD, PLLC Plano, Texas TASCS 2013 Annual Meeting – Houston, TX November 8, 2013

Historical and Projected Number of Medicare Beneficiaries and Number of Workers Per Beneficiary SOURCE: 2010 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds. Number of Beneficiaries (in millions)Number of Workers Per Beneficiary

THE BASICS

CMS ACO Models Pioneer ACO Model No Longer Taking Applications Only 13 of 32 actually generated any shared savings 9 are leaving the program Medicare Shared Savings Program A program that helps fee- for-service providers become an ACO Advanced Payment Plan Supplemental Incentive Program for selected participants in Shared Savings Program

How are beneficiaries assigned to an ACO?

Providers sign agreement to participate with an ACO Patients are assigned to their PCP based on the majority of their outpatient E&M visits PCPs must be exclusive to one ACO Specialists can be part of multiple ACOs These are YOUR existing patients and those of your other ACO members

THE END Raymund C. King, MD, JD (972) Raymund C. King, MD, JD (972)