Aledade Profile picture
Aug 28, 2018 20 tweets 6 min read Twitter logo Read on Twitter
During our #webinar on the #MSSP proposed rule we had a Q&A with @Farzad_MD and @Travis_Broome. We're sharing the most asked questions and answers below.

See the full webinar here:…
Q: Do "low-revenue" ACOs have to enter "Enhanced" track if they have prior experience?
A: No, a low-revenue ACO that is inexperienced with risk can be in the BASIC glide path for agreement period 1 and Level E for their second agreement. More nuanced if experienced with risk
Q: Do percentage regional benchmarks apply to new start ACOs? What does percentage benchmark mean?
A: Regional benchmarks will now start in agreement period 1 (35% for efficient, 25% for inefficient). Independent practices tend to be more regionally efficient!
Q: Can you please elaborate on regional benchmarks?
A: In the old rules the benchmark was can you beat yourself? It was based on your historical costs trended forward. Now 35% of your score (budget) comes from what other Medicare costs in your county are
Q: What is the formula for determining high and low revenue ACOs?
A: Total FFS revenue is: less than 25% of the total FFS expenditures for assigned beneficiaries (low revenue); more than 25% of total FFS expenditures (high revenue)
Q: Is the min saving rate eliminated and if so does this help offset the decrease in saving %?
A: ACOs can choose their MSR/ MLR. If it is lower, they will share more frequently if they get savings. Lowering gameshare means they would share less
Q: How many high revenue acos does Aledade have?
A: We think we don’t have high revenue ACOs (haven’t run the numbers). Low revenue practices have less access to capital and are less able to whether downside risk.
Q: Can an existing ACO add new providers on their panel before expiration date?
A: Any existing ACO, including 2016 starts, can add providers to their existing agreement-- must be done by the end of September
Q: Do payments made in beneficiary incentive program go into the financial rec?
A: Incentive payments have to be paid out of your [ACO] pocket; will not be included in final reconciliation since it is not a payment made by CMS
Q: if ACO improves risk by 3% in first year, can it benefit from that benchmark adjustment for the remaining 4 years?
A: Yes, if it stays that high it would be adjusted up for the entire contract (5 years).
Q: If we are in an ACO for 2018 and plan to join aledade for 2019, how much effort is needing in finishing out our 2018 performance?
A: Still 4 months left in the performance year, you always want to do your best! Push hard on everything you’re doing and good things happen
Q: How does regional benchmarking affect ACOs with participants in different parts of the country?
A: Regional benchmarking will include a weighted average of county-level beneficiary shares
Q: How are CPC+ and Advanced BCPI programs treated?
A: Rule doesn't speak to these, assumption that it continues as is; if we’re sure of the number by the time we settle up on savings, they count as cost of care
Q: If an ACO is in Track 1 and entered their 2nd contract in 2015, can they change their contract or join another ACO in January 2019?
A: There will be no application process for a January 2019 start. Contracts that expire in 2018 can end in Dec or be renewed for 6 months.
Q: Will you still be able to move practices from one ACO to another under this model?
A: In short, yes. There are some nuances of what happens if an ACO crosses a threshold of having more than 50% of previously participating/ experienced physicians though.
Q: Is downside risk measured from baseline or the MLR?
A: Baseline (just like there are first dollar savings, it is first dollar losses)
Q: I'm currently in an ACO, but was planning on switching ACO's 1/1/19. How does this affect my practice now?
A: If it was an existing ACO, you can still be added to their participant list. If it was a new ACO you’ll have to wait until July 2019 when their contract begins
Q: Can you only move sequentially A-B-C etc. each year? Or can you start/move further ahead faster?
A: You can start wherever and move further ahead faster. You can also terminate your BASIC contract at any point and move to ENHANCED without having a “sit-out” period
Do you have a question about the #MSSP proposed rule our Q&A didn't answer? Watch our webinar or tweet us your questions!…

• • •

Missing some Tweet in this thread? You can try to force a refresh

Keep Current with Aledade

Aledade Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!


Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

Did Thread Reader help you today?

Support us! We are indie developers!

This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Don't want to be a Premium member but still want to support us?

Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!


0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy


3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us on Twitter!