American Choice Healthcare (ACH) prides itself on being patient-centered and physician-led, which means that patient care and physician independence have and will continue to be the main drivers of ACH’s success. By joining ACH, you maintain your independence and autonomy as a physician, while entering into a dynamic network of providers focused on quality of care who receive one of the highest shared savings bonuses in the industry on normal Medicare Fee-for-Service rates. ACH providers also benefit from the expertise and guidance of a leadership team with more than 250 years of combined healthcare experience in the fields of population health management, primary-care services, informatics, pharmaceuticals, clinical programs, billing and coding, payer contract negotiations, human resources, and revenue optimization.

American Choice Healthcare (ACH) offers additional support for your office staff, including IT, EMR, and front office support, an extensive preferred provider network that will help increase your share of savings, and care management teams that increase patient satisfaction through telehealth, coordination, and preventive care services.

You can only participate in one Medicare ACO as a Primary-Care Physician. Specialists can join multiple ACOs.

There is absolutely no cost to join American Choice Healthcare ACOs.

No, however, the ACO will educate practices on revenue enhancement opportunities (including billing) while meeting quality measures.

• Pioneer – According to CMS: “The Pioneer ACO Model is a shared savings payment policy with generally higher levels of shared savings and risk for Pioneer ACOs than levels currently proposed in the Medicare Shared Savings Program. In year three of the program, participating ACOs that have shown a specified level of savings over the first two years will be eligible to move a substantial portion of their payments to a population-based model.”
• Medicare Shared Savings Program (“MSSP”) – According to CMS: “The Medicare Shared Savings Program (Shared Savings Program) was established by section 3022 of the Affordable Care Act. The Shared Savings Program is a key component of the Medicare delivery system reform initiatives included in the Affordable Care Act and is a new approach to the delivery of health care. Congress created the Shared Savings Program to facilitate coordination and cooperation among providers to improve the quality of care for Medicare Fee-For-Service (FFS) beneficiaries and reduce unnecessary costs. Eligible providers, hospitals, and suppliers may participate in the Shared Savings Program by creating or participating in an Accountable Care Organization (ACO).”
• Next Generation – According to CMS: “The Next Generation ACO Model is an initiative for ACOs that are experienced in coordinating care for populations of patients. It will allow these provider groups to assume higher levels of financial risk and reward than are available under the current Pioneer Model and Shared Savings Program (MSSP). The goal of the Model is to test whether strong financial incentives for ACOs, coupled with tools to support better patient engagement and care coordination, can improve health outcomes and lower expenditures for Original Medicare fee-for-service (FFS) beneficiaries.
• Medicare/Medicaid – According to CMS: “The Medicare-Medicaid ACO (MMACO) Model is focused on improving quality of care and reducing costs for Medicare-Medicaid enrollees. The MMACO Model builds on the Medicare Shared Savings Program (Shared Savings Program), in which groups of providers take on accountability for the Medicare costs and quality of care for Medicare patients. Through the Model, CMS will partner with interested states to offer new and existing Shared Savings Program ACOs the opportunity to take on accountability for the Medicaid costs for their assigned Medicare-Medicaid enrollees.”

As explained by CMS: “Medicare ACOs can choose to accept either one-sided or two-sided financial risk.”

• Track 1: Under the one-sided model, an ACO may receive shared savings if it meets the applicable requirements, but it will not be liable for shared losses.
• Track 1+: The new Model is based on the Shared Savings Program Track 1, but incorporates elements of Track 3 including: prospective beneficiary assignment to allow ACOs to know in advance the patient population for which they are responsible; the introduction of downside risk (although lower than Track 3); and the option to request a Skilled Nursing Facility (SNF) 3-Day Rule Waiver to provide greater flexibility to Track 1+ ACOs to better coordinate and deliver high quality care.
• Track 2: Under the two-sided models (Track 2 and Track 3), the ACO may share both savings and losses. This policy provides an opportunity for more experienced ACOs to enter a sharing arrangement that provides a greater share of savings, but with the responsibility of repaying Medicare a portion of any losses. In MSSP, Track 2 ACOs can earn up to 60% of any savings, while
• Track 3: Similar to Track 2, the ACO may share both savings and losses. Track 3 ACOs see maximum shared savings rates of 75%.

As explained by CMS: “Under the program regulations, Medicare continues to pay individual ACO providers and suppliers for covered items and services as it currently does under the Medicare Fee-For-Service payment systems. CMS also develops a benchmark for each ACO against which ACO performance is measured to assess whether the ACO generated savings or losses for the Medicare program during a performance year. ACOs that meet or exceed a minimum savings rate (MSR), satisfy minimum quality performance standards, and otherwise maintain their eligibility to participate in the Shared Savings Program are eligible to receive a portion of the savings they generate (“shared savings”). In addition, if an ACO has chosen to operate under a two-sided risk model, and it meets or exceeds a minimum loss rate (MLR), it must repay a portion of the losses it generates (“shared losses”).”

Specific program enrollment deadlines vary. Use the Contact Us page to start the process.

Yes.

Yes.

Yes.

Yes. As a participant in American Choice Healthcare ACOs,  you are supported by a team of MACRA experts who will help you successfully meet all requirements. You will be joining a team that has consistently achieved high quality scores.

MACRA, which heavily pushes forward ACO models, recently passed both houses handily. Medicare Alternative Payment Models have been bipartisan.

Clif Gaus, President, and CEO of the National Association of ACOs (NAACOS) recently stated:

“Observers at NAACOS are hearing from congressional contacts that ACOs are not part of any repeal. Their value holds up as a market-based alternative to fee-for-service at one extreme and capitation at the other, and with 200,000 physicians participating, Tom Price will recognize that and support an advanced payment model for physicians with the goal of population health management.”

Medicare Advantage plan patients cannot participate in Medicare ACOs; however, American Choice Healthcare (ACH) does provide a Management Services Organization that contracts with several Medicare Advantage Plans for which you may be eligible.

American Choice Healthcare (ACH) practices population health and can therefore improve your patient experience. ACH provides your physician with the tools to help you get the right care at the right time for the right reasons. We will also help make certain that you are seeing the best doctors through our extensive provider network by closely working with your Primary-Care Physician. We will provide your physician with educational resources to help you navigate your health care plan.

As explained by the Centers for Medicare & Medicaid Services (CMS), “when your health care providers participate in an ACO, you should see better, more coordinated care over time. With an ACO, you’re the center of care, and your satisfaction is one of the goals. Over time, you may notice that:

• You don’t have to fill out as many medical forms that ask for the same information.
• The health care providers that you see all know what’s going on with your health because they communicate with each other.
• You don’t need to repeat medical tests because your results are shared among your health care team.
• The providers participating in the ACO will work with you to make sure their health care decisions reflect your preferences.”

No. All of your Medicare benefits remain the same. You can visit any physician without a referral, however, we do encourage you to utilize your Primary-Care Physician so they can fully ensure the best quality of care.

There is absolutely no cost to you or your doctor.

For a patient to be attributed to an ACO, their Primary-Care Physician must be an ACO participant. If you are interested in seeing a physician in our ACO, search our Directory, or alternatively contact us today and speak to your Primary-Care Physician.

Federal law protects the privacy and security of your medical information. The group of doctors, hospitals, and other health care providers in the ACO working together on your behalf will be able to read your medical records, along with other office staff authorized to help coordinate your care. Each of your health care providers won’t only know about the health issues that they’ve treated, they’ll have a more complete picture of your health by sharing information with your other health care providers.

Contact your doctor’s office for more information about how they protect your medical information, or call 1-800-MEDICARE to learn more about how Medicare protects your medical information.

When a doctor participates in the ACO, their patients or beneficiaries are not participants. Patients of participating ACO physicians benefit from the highest quality of care, at the right time, and in the right setting.

Ask your physician if they participate in an ACO. If so, they can provide you with additional information. If not, encourage them to participate in an ACO today.

MACRA, which heavily pushes forward ACO models, recently passed both houses handily. Medicare Alternative Payment Models have been bipartisan.

Clif Gaus, President and CEO of the National Association of ACOs (NAACOS) recently stated:

“Observers at NAACOS are hearing from congressional contacts that ACOs are not part of any repeal. Their value holds up as a market-based alternative to fee-for-service at one extreme and capitation at the other, and with 200,000 physicians participating, Tom Price will recognize that and support an advanced payment model for physicians with the goal of population health management.”

f you previously declined to share information about your health care with your doctor and wish to change your consent preferences, please call 1-800-MEDICARE.

If you do not wish to allow Medicare to share information about your health care with your doctor, please call 1-800-MEDICARE. Please know that the information that Medicare has about your health care is valuable in helping us provide the highest levels of coordinated care and to better meet your health care needs.

For general questions or additional information about ACOs, please visit CMS or call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.