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ACO-to-MA Transition Involves Broad Array of Rules, Requirements, But Could Reap Financial Rewards, Reports ACO Business News
Date:9/5/2013

Washington, DC (PRWEB) September 05, 2013

Medicare Shared Savings Program (MSSP) and Pioneer accountable care organizations that want to open Medicare Advantage (MA) plans will need to consider how to address a broad array of requirements ranging from insurance reserves to compliance issues, reports the September issue of Atlantic Information Services, Inc.’s (AIS) ACO Business News in an overview of an Aug. 8 webinar co-hosted by AIS and Gorman Health Group, LLC (GHG).

ACOs that do make the move could see financial rewards that well exceed the possible shared savings from the two Medicare ACO programs, GHG senior vice president, finance, William MacBain told webinar attendees. However, it’s not a strategy that will suit every organization, he added. “This is for Medicare ACOs looking for an exit strategy: provider organizations who have tasted risk and like it, but are looking for something that does not have the sort of issues that Medicare ACO programs have.”

Choosing to become an MA plan involves a move upstream to the payer side and involves more complex issues, while staying on the provider side and sharing risk as a network contracted with MA plans might “look something like what you’re doing now as an ACO, or moving further into full capitation,” MacBain said. Either option, he added, could represent a successful strategy for a current Medicare ACO.

Visit http://aishealth.com/archive/nabn0913-05 to read the article in its entirety, which also includes analysis of the hurdles ACOs may face in transitioning to MA plans from Regan Pennypacker, GHG’s senior director of compliance solutions, and Aaron Eaton, GHG’s chief development officer. For more information about the Aug. 8 webinar and to order a reco
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