ACO Membership Benefits

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
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