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Advance Payment ACO Model

Advance Payment ACO Model

This model  has been designed to be used by rural  providers and physician based providers who have  joined hands together in giving coordination of high quality health care  to the Medicare patients they provide the service.  Through this model the selected supervisors receive monthly upfront payments which they then use in making essential investments in the infrastructure for care coordination (CMS, n.d). In the beginning years of his model, the payment models that had been tested shared a payment policy for savings that had higher risks and shared savings for the Pioneer ACOs than those recommended in Shared Savings Program.  The aim of this model is to offer higher quality care that is seamless (CMS, n.d).

This model is very useful for health care providers and organization that have experience in the coordination of patient care across various settings of care.  The payment models involved in this initiative incorporate risk utilization and require that healthcare providers participate in the management of population.  Hence, in general terms the model aims at fulfilling the intentions of Affordable Care Act by improving outcomes for beneficiaries and increasing value of the offered care (Partners Healthcare, 2014). This is achieved through the provision of better healthcare for individuals and populations and reducing growth in healthcare expenditures.  Providers who participate in the Pioneer ACO are not affected in regard to how they provide healthcare to their patients.  In the billing process where partners meet the requirements for Pioneer ACO program in the first and second year, there is an option in the third year for putting in place a payment system that is population based (Partners Healthcare, 2014). It is an efficient model that ensures reduction of healthcare cost.

Reference

CMS, (n.d)Pioneer ACO Model. Retrieved from: https://innovation.cms.gov/initiatives/Pioneer-ACO-Model/

Partners Healthcare, (2014).Pioneer Accountable Care Organization (ACO) Program Frequently Asked Questions for Providers. Retrieved from: https://www.partners.org/Assets/Documents/For-Medical-Professionals/ACO/Pioneer_Accountable_Care_Organization_Provider_FAQs.pdf

 

 

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