For independent primary care practices, the upside of adopting value-based care can be significant: increased revenue, more efficient workflows, and more accessible, impactful patient data. While data shows physician-led Accountable Care Organizations (ACOs) outperform other models, the process of transitioning is often more challenging for independent practices with limited human, technical, and financial resources.
With value-based care, physicians are reimbursed based on quality rather than volume. The goal is to support patients at their highest possible level of wellness rather than wait to provide care until they get sick, which is often more complex and expensive.
In value-based care arrangements, physicians contract with payers, such as Medicare, Medicaid, and commercial insurance companies, to care for a defined set of patients. Physicians can earn financial rewards by meeting specific performance and quality measures tied to better long-term outcomes for patients. These measures may include the delivery of routine and preventive care services and chronic disease management services.
Accountable care organizations, or ACOs, help physicians formalize their approach to value-based care. ACOs are groups of practices that contract with a payer to achieve the shared goals of improving outcomes and reducing unnecessary spending.
As the top-rated, physician-led ACO in the country, Aledade’s proven process helps practices quickly improve financial performance and get more from the data and technologies they have. In 2020, 92 percent of Aledade Medicare Shared Savings Program (MSSP) ACOs achieved savings, reducing the cost of care by 7.4 percent, saving Medicare $315 million. For their success and work in providing care to over 400,000 Medicare patients, Aledade practices will share in over $93 million.
At the same time, Aledade’s multi-payer ACOs also created savings — more than $146 million in total with over $50 million going to Aledade practices for quality care delivered to over 376,000 commercial, Medicare Advantage and Medicaid patients.
Aledade recognizes that primary care doctors cannot make the shift to value-based care alone. They need and want a partner who understands their unique needs, and who can provide regulatory expertise, cutting edge technology, data analytics, business transformation services, and all the other elements they need to succeed in value-based healthcare.
CAP primary care practices considering joining an ACO can take advantage of the opportunity to determine their potential shared savings revenue at
CAP continues to work with Aledade, a company committed to helping medical practices thrive in value-based care programs, as a participant in the CAPAdvantage program to help our members’ practices increase revenue and improve outcomes.
If you would like to learn more about the no-cost or discounted products and services exclusive to CAP members available through the CAPAdvantage program or would like assistance with general business or practice-related inquiries, please contact Andie Tena, CAP’s Director of Practice Management Services, at ATena@CAPphysicians.com or call 213-473-8630.