Member Benefits

Beaumont ACO Benefits

• Low cost, one-time capital call payment of $250, gets you access to participation in our 14 payer contracts.
• Payer contracts represent several lines of business, including the major payers/programs in our market.
• Market competitive reimbursement terms with a physician reimbursement focus.
• Access to Pay for Value based programs such as PGIP and MSSP.

Medicare Shared Savings Program - MSSP

• Top performing year-over-year Medicare Shared Savings ACO, with five years of continuous earned payments.

• $163.3 Million in Savings Created, $74.1 Million Shared with the ACO
• $44.4 Million Distributed to ACO Providers
• Performance Score in Quality Reporting of 92.6% achieved

• Access to our Advanced Illness Management (AIM) program for patients in need of additional care management services.

• Free of charge to provider and patient
• Telephonic and In-Home patient support
• Collaborative relationship between PCP, Patient, and AIM Team

Blue Cross Blue Shield Michigan – Physician Group Incentive Program – PGIP

• Proven track record and road map for success with Patient Centered Medical Home (PCMH) Designation
• Dedicated ACO resource to assist your practice in achieving PCMH Designation
• PCP Value Based Reimbursements (VBRs) of up to 50 percent, based on PCMH Designation status and Quality, Utilization, and Efficiency performance
• The average ACO PCP received Distributions and VBRs of roughly $17,000 each last year.

BCBSM Blue Print 
(Contract Effective date of January 1st, 2021 and runs for 5 years)

• Upside risk sharing based on cost and quality performance and attributed patient, and roughly 3-5 times higher than downside risk
• 2% withhold on Fee-For-Service claims to cover downside risk, returned to provider if performance is Positive 

• Provider risk is limited to withhold only, additional risk will be held by Beaumont ACO at the corporate level

Additional Beaumont ACO Benefits

• Steady growth of membership and covered lives
• Use of a Patient Registry to close gaps in care
• Quality reporting via MSSP staff support, satisfying MIPS reporting requirements
• Interfaces to payers/programs to receive credit for gap closures, enhancing performance payouts
• Provision of analytics to better enable understanding of performance and ways to improve it
• Strong partnership with Beaumont Health