For nearly two decades, Better Health Group has been a leader in value-based care and operating top-rated primary care clinics. Our network of owned and independent clinics leverage our model to improve care for both Medicare Advantage (MA) and Traditional Medicare patients. Now, the Centers for Medicare & Medicaid Services (CMS) has ranked Better Health Group in the top 5% of Medicare Shared Savings Program (MSSP), Accountable Care Organizations (ACOs) for performance year 2023.
At a time when independent clinics face mounting challenges, our providers are exceeding CMS quality goals and maximizing shared savings revenue, in every state in which we operate—Florida, Alabama, Georgia, Texas, Oklahoma, and Tennessee.
Most of the hesitation around joining an MSSP ACO comes down to not knowing exactly what you're signing up for. What changes, what stays the same and what does the financial picture actually look like?
First, the one thing that doesn't change: your fee-for-service billing
Your existing Medicare billing stays exactly as it is. CMS still pays your claims under the Physician Fee Schedule. You don't swap your current revenue for something new, instead you add to it.
Now, here's what does change.
1. You have a second revenue stream
On top of your fee-for-service billing, you now have the opportunity to earn shared savings — a portion of the money CMS saves when your attributed patient panel costs less to care for than the benchmark CMS set. That benchmark is based on what CMS would historically have spent on patients like yours.
Practices in BHG's MSSP ACO network have averaged over $1,000 per patient per year in additional revenue. For a practice with 300 Traditional Medicare patients, that's a meaningful number.
2. You get paid for the work that was previously invisible
Fee-for-service pays for the visit. It doesn't pay for the care coordination call, the proactive gap closure, the hospital discharge follow-up, or the chronic disease management between appointments. In the MSSP model, all of that work shows up in your quality scores and your benchmark performance and it generates real revenue. For the first time, doing the right thing for the patient is also the right thing for your bottom line.
3. Quality scores become part of your financial picture
MSSP participation links part of your shared savings potential to your performance on quality measures like HEDIS scores, Annual Wellness Visit delivery rates, MIPS reporting and chronic disease management metrics. This requires systematic attention to documentation and care gap closure, which is exactly the kind of operational support a strong ACO partner provides. Better Health Group's ACO network averaged an 85.7% quality score in Performance Year 2024, compared to the national ACO average of 81.9%.
4. Your patient panel becomes a measurable financial asset
In fee-for-service, 350 attributed Medicare patients is a volume metric. In the MSSP model, that same panel is the foundation of your performance calculation. Practices with complex, high-cost patient populations can actually benefit more from the model, because there's more opportunity to reduce spending from a higher baseline.
5. Administrative burden can shift off your plate
Quality reporting, care management documentation, MIPS compliance doesn’t disappear in a value-based model. But the right ACO partner helps simplify workflows to streamline your administrative workload.
6. Downside risk is real — but manageable with the right partner
The Enhanced Track of the MSSP — the highest-reward level — does include downside risk: if spending exceeds the benchmark in a given year, practices can owe money back to CMS. Whether that risk is realized depends almost entirely on the quality of the ACO's population health infrastructure.
7. Timing is fixed — and missing the window is expensive
Fee-for-service doesn't have enrollment windows. MSSP does. CMS sets a hard annual deadline, and for PY2027 that deadline is August 5, 2026. Miss it and the next opportunity is 2028. That's not just a year of missed shared savings — it's a year of missed benchmark refinement, quality data accumulation and operational learning that compounds over multiple years. The practices generating the strongest MSSP results today are the ones that enrolled early.
Most of the hesitation around joining an MSSP ACO comes down to not knowing exactly what you're signing up for. What changes, what stays the same and what does the financial picture actually look like?
First, the one thing that doesn't change: your fee-for-service billing
Your existing Medicare billing stays exactly as it is. CMS still pays your claims under the Physician Fee Schedule. You don't swap your current revenue for something new, instead you add to it.
Now, here's what does change.
1. You have a second revenue stream
On top of your fee-for-service billing, you now have the opportunity to earn shared savings — a portion of the money CMS saves when your attributed patient panel costs less to care for than the benchmark CMS set. That benchmark is based on what CMS would historically have spent on patients like yours.
Practices in BHG's MSSP ACO network have averaged over $1,000 per patient per year in additional revenue. For a practice with 300 Traditional Medicare patients, that's a meaningful number.
2. You get paid for the work that was previously invisible
Fee-for-service pays for the visit. It doesn't pay for the care coordination call, the proactive gap closure, the hospital discharge follow-up, or the chronic disease management between appointments. In the MSSP model, all of that work shows up in your quality scores and your benchmark performance and it generates real revenue. For the first time, doing the right thing for the patient is also the right thing for your bottom line.
3. Quality scores become part of your financial picture
MSSP participation links part of your shared savings potential to your performance on quality measures like HEDIS scores, Annual Wellness Visit delivery rates, MIPS reporting and chronic disease management metrics. This requires systematic attention to documentation and care gap closure, which is exactly the kind of operational support a strong ACO partner provides. Better Health Group's ACO network averaged an 85.7% quality score in Performance Year 2024, compared to the national ACO average of 81.9%.
4. Your patient panel becomes a measurable financial asset
In fee-for-service, 350 attributed Medicare patients is a volume metric. In the MSSP model, that same panel is the foundation of your performance calculation. Practices with complex, high-cost patient populations can actually benefit more from the model, because there's more opportunity to reduce spending from a higher baseline.
5. Administrative burden can shift off your plate
Quality reporting, care management documentation, MIPS compliance doesn’t disappear in a value-based model. But the right ACO partner helps simplify workflows to streamline your administrative workload.
6. Downside risk is real — but manageable with the right partner
The Enhanced Track of the MSSP — the highest-reward level — does include downside risk: if spending exceeds the benchmark in a given year, practices can owe money back to CMS. Whether that risk is realized depends almost entirely on the quality of the ACO's population health infrastructure.
7. Timing is fixed — and missing the window is expensive
Fee-for-service doesn't have enrollment windows. MSSP does. CMS sets a hard annual deadline, and for PY2027 that deadline is August 5, 2026. Miss it and the next opportunity is 2028. That's not just a year of missed shared savings — it's a year of missed benchmark refinement, quality data accumulation and operational learning that compounds over multiple years. The practices generating the strongest MSSP results today are the ones that enrolled early.
Most of the hesitation around joining an MSSP ACO comes down to not knowing exactly what you're signing up for. What changes, what stays the same and what does the financial picture actually look like?
First, the one thing that doesn't change: your fee-for-service billing
Your existing Medicare billing stays exactly as it is. CMS still pays your claims under the Physician Fee Schedule. You don't swap your current revenue for something new, instead you add to it.
Now, here's what does change.
1. You have a second revenue stream
On top of your fee-for-service billing, you now have the opportunity to earn shared savings — a portion of the money CMS saves when your attributed patient panel costs less to care for than the benchmark CMS set. That benchmark is based on what CMS would historically have spent on patients like yours.
Practices in BHG's MSSP ACO network have averaged over $1,000 per patient per year in additional revenue. For a practice with 300 Traditional Medicare patients, that's a meaningful number.
2. You get paid for the work that was previously invisible
Fee-for-service pays for the visit. It doesn't pay for the care coordination call, the proactive gap closure, the hospital discharge follow-up, or the chronic disease management between appointments. In the MSSP model, all of that work shows up in your quality scores and your benchmark performance and it generates real revenue. For the first time, doing the right thing for the patient is also the right thing for your bottom line.
3. Quality scores become part of your financial picture
MSSP participation links part of your shared savings potential to your performance on quality measures like HEDIS scores, Annual Wellness Visit delivery rates, MIPS reporting and chronic disease management metrics. This requires systematic attention to documentation and care gap closure, which is exactly the kind of operational support a strong ACO partner provides. Better Health Group's ACO network averaged an 85.7% quality score in Performance Year 2024, compared to the national ACO average of 81.9%.
4. Your patient panel becomes a measurable financial asset
In fee-for-service, 350 attributed Medicare patients is a volume metric. In the MSSP model, that same panel is the foundation of your performance calculation. Practices with complex, high-cost patient populations can actually benefit more from the model, because there's more opportunity to reduce spending from a higher baseline.
5. Administrative burden can shift off your plate
Quality reporting, care management documentation, MIPS compliance doesn’t disappear in a value-based model. But the right ACO partner helps simplify workflows to streamline your administrative workload.
6. Downside risk is real — but manageable with the right partner
The Enhanced Track of the MSSP — the highest-reward level — does include downside risk: if spending exceeds the benchmark in a given year, practices can owe money back to CMS. Whether that risk is realized depends almost entirely on the quality of the ACO's population health infrastructure.
7. Timing is fixed — and missing the window is expensive
Fee-for-service doesn't have enrollment windows. MSSP does. CMS sets a hard annual deadline, and for PY2027 that deadline is August 5, 2026. Miss it and the next opportunity is 2028. That's not just a year of missed shared savings — it's a year of missed benchmark refinement, quality data accumulation and operational learning that compounds over multiple years. The practices generating the strongest MSSP results today are the ones that enrolled early.