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ACO-to-MA Transition Involves Broad Array of Rules, Requirements, But Could Reap Financial Rewards, Reports ACO Business News

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 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 recording, visit

About ACO Business News
ACO Business News delivers timely news and business strategies on accountable care organizations for physicians and provider groups, hospitals, health plans and their advisers. The monthly newsletter covers the latest industry actions to design and create ACOs, results that are already being achieved by ACO-like entities, and HHS regulations and guidance on this provocative new trend in health care. Featuring the pros and cons of various strategies for different types of organizations, ACO Business News is designed to help readers avoid the pitfalls ahead and transform exciting ACO opportunities into winning business strategies. Visit to learn more.

About Atlantic Information Services
Atlantic Information Services, Inc. (AIS) is a publishing and information company that has been serving the health care industry for more than 25 years. It develops highly targeted news, data and strategic information for managers in hospitals, health plans, medical group practices, pharmaceutical companies and other health care organizations. AIS products include print and electronic newsletters, websites, looseleafs, books, strategic reports, databases, webinars and conferences. Learn more at

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