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Primary Care Physicians and ACOs

ACO Series: Part 2

ACOs are groups of clinicians and organizations that band together to save Medicare money by keeping beneficiaries healthy. Who better to monitor patients care and provide preventive medicine than a primary care physician? Primary care physicians and ACOs, with the right guidance, can get bonuses of $50-$100k each year in addition to your regular fee-for-service income. This is the program for you.

Before you sign up for your local hospital’s ACO, consider this…

Of the top 20 performing ACOs in 2017, only 30% were hospital-led. Hospitals with an integrated delivery network (a care continuum) have a vested interest in growing expenditures. To them, a 10% Medicare savings is synonymous with a 10% reduction in revenue; the incentive is nonexistent.

Thus, physician groups have stronger incentives as ACOs to limit utilization and pursue systemic strategies that affect all their patients, without having to rely on efforts that target specific patients.

Hospitals cannot sacrifice the fee-for-service revenue they rack in from inpatient admissions. Already amassing capital, there is truly no enticement for hospital-led ACOs to lessen their Medicare costs. This is in polarity to the physician groups that see a 10% Medicare savings as an increase to their revenues.

So, what?

Join a physician-led ACO or start your own. Create your own governance structure, your own care paths, and put the focus on your own profession: primary care. You won’t be weighed down by insurance plans or the financial interests of the hospital; you call the shots. With the help and guidance of the right partner, your ACO will not only save the Medicare program some serious money, but you will get a share of it. When the ACO is successful, everyone wins: you, the beneficiary, and the economy.

Primary care is proven to be the number one most effective resource in curbing healthcare costs. However, this does not mean that there is not a place for specialists in an ACO. Find out more in Part 3!

Be sure to keep up with this 4-part series as we explore other FAQs about Accountable Care Organizations such as How Do I Start an ACO? Up Next: I’m a Specialist, Should I Join an ACO?

 

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