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More than one-third of U.S. healthcare payments flow through an advanced payment model (APM), such as shared savings, shared risk or capitated payment. Yet for the majority of physician practices, most of their revenue is not tied to risk-based arrangements, leading to significant opportunities to participate in these models.
Accountable care organizations (ACOs) can be a good starting point for an APM journey because this type of model starts with upside risk only, which allows practices to test the waters before wading into more complex arrangements that require them to assume greater risk. While not the most flexible type of value-based care model, ACOs do offer greater flexibility than fee-for-service, paying providers for things like provider collaboration and care management, while addressing social determinants of health and more.
To realize strong clinical and financial results with an ACO model, it is critical to choose one that aligns with your practice’s mission, values, and strategic priorities. In addition, you should look for one that is committed to robust communication and support throughout the relationship. What does that look like in practice? Here are some key areas to assess.