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.
Don’t Choose an IPA, MSO, or ACO for the Wrong Reason
On the surface, many IPAs (Independent Physician Associations), ACOs (Accountable Care Organizations) and MSOs (Managed Service Organizations) offer similar services to get you to join their value-based care network and payer contracts. These usually include tools that give you more information on your patients, reports to help you understand your performance, help with administrative tasks, and they may even offer up-front cash to get you to join. But how can you be sure you’re picking a partner that actually helps you run a better business and practice better medicine?
1. Your partner should actually run primary care clinics.
While many MSOs and ACOs tout being physician-led, they don’t own or operate clinics. While the revenue gains they offer sound good, in the real world, their playbooks tax independent clinics with more boxes to check and lists to work, and the real financial benefit they provide rarely covers the actual time and cost to get it.
Great value-based care partners also run great primary care clinics. Their clinicians have input on the tools they offer and workflows they recommend. These “peer led MSOs” have integrated value-based care into the clinic operating model and they do it across all lines of business: ACO MSSP, MA and Medicaid. They create extra value instead of extra work, giving your team better information that speeds and simplifies care management and improves the accuracy of coding and billing.
What To Ask:
- How many patients per day do your clinicians see?
- Can you show me your performance with health plans, including MA and Medicaid?
- How much time is your system going to take from my office staff?
2. Your partner should pay based on your performance and help you earn new revenue, faster.
Most clinics in value-based programs do earn some extra money, but their “shared savings” or “surplus” are based on how well the collective ACO or MSO reduces overall costs for the payer. With most partners, savings are shared among their network based on the number of patients a clinic has, or distributed with minor adjustments for doing better or worse on quality checklists. This means your clinic could deliver excellent results and still walk away empty-handed or with a far lower share of savings than you actually earned.
In addition, for many clinics, even those that perform well in value-based agreements, revenue is something they need help with right now. Unfortunately, if you do earn shared savings, those revenues are not guaranteed and it could be several months - or years - before you see payment.
A great partner won’t put you in a pool where you’re penalized for the poor results of others. Rather, they protect your clinic from downside financial risk, pay you based on your own performance, and have programs that create guaranteed value sooner instead of making you wait months or years to get paid.
What To Ask:
- Are poor performers going to drag my revenue down?
- If your MSO/IPA/ACO misses on MA targets, will I still get paid if I do well?
- Do you offer revenue guarantees, and how long until I see a change in my cash flow?
3. Your partner should really know risk.
How much your clinic can earn in value-based care often depends on the level of risk your MSO is willing to take on. The greater the risk they are capable of assuming with a payer, the greater the potential reward for your clinic.
For ACOs, the maximum you can earn in Basic ACO models is less than in Enhanced models, where the risk and reward are higher. Basic ACOs are eligible to receive a maximum of 40-50% share of the savings their network creates, where Enhanced ACOs can garner up to 75%. A larger share of total savings means more can be shared with your clinic.
And for MA arrangements, which are more complex, many MSOs may claim to take on “full risk,” but, in reality, they only assume risk for the primary care portion of total healthcare spending. Even if your clinic performs exceptionally well, your earnings are capped because of your value-based partner’s inability to take on true “global risk” and positively impact both quality and the total cost of care.
Additionally, annual MA benefit design changes that payers make – usually in an attempt to add new members – can have a dramatic impact on your opportunity. Lack of a medical economics team to analyze the impact of these changes and work with payers to make adjustments to your program can leave both you and your value-based partner with losses instead of gains.
Great value-based care partners know how to handle the complexities of global risk agreements to help your clinic earn more (without costing you money) and they offer rolling enrollment for their value-based contracts so you don’t have to wait to get started. They also offer protection from financial downside risk and payer benefit design changes, plus expert guidance that keeps you moving in the right direction with all payers and offer programs with unlimited reward opportunity.
What To Ask:
- Do you take on partial or global risk in your MA contracts, and how will you protect my clinic from the changes payers make to benefit design?
- Is your ACO in the highest risk-reward level, “Enhanced” ACO MSSP track?
- Is rolling enrollment available for MA or Medicaid, or do I have to wait to start?
The time to decide is now.
For nearly two decades, Better Health Group has operated owned clinics and partnered with independent primary care providers to deliver better care, better outcomes, and better business results. Our top-rated primary care clinics consistently exceed CMS quality goals, reduce total cost of care, and maximize revenue across for all of your Medicare patients, a performance that places our network in the top 5% of Medicare ACOs nationwide.
Don’t Choose an IPA, MSO, or ACO for the Wrong Reason
On the surface, many IPAs (Independent Physician Associations), ACOs (Accountable Care Organizations) and MSOs (Managed Service Organizations) offer similar services to get you to join their value-based care network and payer contracts. These usually include tools that give you more information on your patients, reports to help you understand your performance, help with administrative tasks, and they may even offer up-front cash to get you to join. But how can you be sure you’re picking a partner that actually helps you run a better business and practice better medicine?
1. Your partner should actually run primary care clinics.
While many MSOs and ACOs tout being physician-led, they don’t own or operate clinics. While the revenue gains they offer sound good, in the real world, their playbooks tax independent clinics with more boxes to check and lists to work, and the real financial benefit they provide rarely covers the actual time and cost to get it.
Great value-based care partners also run great primary care clinics. Their clinicians have input on the tools they offer and workflows they recommend. These “peer led MSOs” have integrated value-based care into the clinic operating model and they do it across all lines of business: ACO MSSP, MA and Medicaid. They create extra value instead of extra work, giving your team better information that speeds and simplifies care management and improves the accuracy of coding and billing.
What To Ask:
- How many patients per day do your clinicians see?
- Can you show me your performance with health plans, including MA and Medicaid?
- How much time is your system going to take from my office staff?
2. Your partner should pay based on your performance and help you earn new revenue, faster.
Most clinics in value-based programs do earn some extra money, but their “shared savings” or “surplus” are based on how well the collective ACO or MSO reduces overall costs for the payer. With most partners, savings are shared among their network based on the number of patients a clinic has, or distributed with minor adjustments for doing better or worse on quality checklists. This means your clinic could deliver excellent results and still walk away empty-handed or with a far lower share of savings than you actually earned.
In addition, for many clinics, even those that perform well in value-based agreements, revenue is something they need help with right now. Unfortunately, if you do earn shared savings, those revenues are not guaranteed and it could be several months - or years - before you see payment.
A great partner won’t put you in a pool where you’re penalized for the poor results of others. Rather, they protect your clinic from downside financial risk, pay you based on your own performance, and have programs that create guaranteed value sooner instead of making you wait months or years to get paid.
What To Ask:
- Are poor performers going to drag my revenue down?
- If your MSO/IPA/ACO misses on MA targets, will I still get paid if I do well?
- Do you offer revenue guarantees, and how long until I see a change in my cash flow?
3. Your partner should really know risk.
How much your clinic can earn in value-based care often depends on the level of risk your MSO is willing to take on. The greater the risk they are capable of assuming with a payer, the greater the potential reward for your clinic.
For ACOs, the maximum you can earn in Basic ACO models is less than in Enhanced models, where the risk and reward are higher. Basic ACOs are eligible to receive a maximum of 40-50% share of the savings their network creates, where Enhanced ACOs can garner up to 75%. A larger share of total savings means more can be shared with your clinic.
And for MA arrangements, which are more complex, many MSOs may claim to take on “full risk,” but, in reality, they only assume risk for the primary care portion of total healthcare spending. Even if your clinic performs exceptionally well, your earnings are capped because of your value-based partner’s inability to take on true “global risk” and positively impact both quality and the total cost of care.
Additionally, annual MA benefit design changes that payers make – usually in an attempt to add new members – can have a dramatic impact on your opportunity. Lack of a medical economics team to analyze the impact of these changes and work with payers to make adjustments to your program can leave both you and your value-based partner with losses instead of gains.
Great value-based care partners know how to handle the complexities of global risk agreements to help your clinic earn more (without costing you money) and they offer rolling enrollment for their value-based contracts so you don’t have to wait to get started. They also offer protection from financial downside risk and payer benefit design changes, plus expert guidance that keeps you moving in the right direction with all payers and offer programs with unlimited reward opportunity.
What To Ask:
- Do you take on partial or global risk in your MA contracts, and how will you protect my clinic from the changes payers make to benefit design?
- Is your ACO in the highest risk-reward level, “Enhanced” ACO MSSP track?
- Is rolling enrollment available for MA or Medicaid, or do I have to wait to start?
The time to decide is now.
For nearly two decades, Better Health Group has operated owned clinics and partnered with independent primary care providers to deliver better care, better outcomes, and better business results. Our top-rated primary care clinics consistently exceed CMS quality goals, reduce total cost of care, and maximize revenue across for all of your Medicare patients, a performance that places our network in the top 5% of Medicare ACOs nationwide.
Don’t Choose an IPA, MSO, or ACO for the Wrong Reason
On the surface, many IPAs (Independent Physician Associations), ACOs (Accountable Care Organizations) and MSOs (Managed Service Organizations) offer similar services to get you to join their value-based care network and payer contracts. These usually include tools that give you more information on your patients, reports to help you understand your performance, help with administrative tasks, and they may even offer up-front cash to get you to join. But how can you be sure you’re picking a partner that actually helps you run a better business and practice better medicine?
1. Your partner should actually run primary care clinics.
While many MSOs and ACOs tout being physician-led, they don’t own or operate clinics. While the revenue gains they offer sound good, in the real world, their playbooks tax independent clinics with more boxes to check and lists to work, and the real financial benefit they provide rarely covers the actual time and cost to get it.
Great value-based care partners also run great primary care clinics. Their clinicians have input on the tools they offer and workflows they recommend. These “peer led MSOs” have integrated value-based care into the clinic operating model and they do it across all lines of business: ACO MSSP, MA and Medicaid. They create extra value instead of extra work, giving your team better information that speeds and simplifies care management and improves the accuracy of coding and billing.
What To Ask:
- How many patients per day do your clinicians see?
- Can you show me your performance with health plans, including MA and Medicaid?
- How much time is your system going to take from my office staff?
2. Your partner should pay based on your performance and help you earn new revenue, faster.
Most clinics in value-based programs do earn some extra money, but their “shared savings” or “surplus” are based on how well the collective ACO or MSO reduces overall costs for the payer. With most partners, savings are shared among their network based on the number of patients a clinic has, or distributed with minor adjustments for doing better or worse on quality checklists. This means your clinic could deliver excellent results and still walk away empty-handed or with a far lower share of savings than you actually earned.
In addition, for many clinics, even those that perform well in value-based agreements, revenue is something they need help with right now. Unfortunately, if you do earn shared savings, those revenues are not guaranteed and it could be several months - or years - before you see payment.
A great partner won’t put you in a pool where you’re penalized for the poor results of others. Rather, they protect your clinic from downside financial risk, pay you based on your own performance, and have programs that create guaranteed value sooner instead of making you wait months or years to get paid.
What To Ask:
- Are poor performers going to drag my revenue down?
- If your MSO/IPA/ACO misses on MA targets, will I still get paid if I do well?
- Do you offer revenue guarantees, and how long until I see a change in my cash flow?
3. Your partner should really know risk.
How much your clinic can earn in value-based care often depends on the level of risk your MSO is willing to take on. The greater the risk they are capable of assuming with a payer, the greater the potential reward for your clinic.
For ACOs, the maximum you can earn in Basic ACO models is less than in Enhanced models, where the risk and reward are higher. Basic ACOs are eligible to receive a maximum of 40-50% share of the savings their network creates, where Enhanced ACOs can garner up to 75%. A larger share of total savings means more can be shared with your clinic.
And for MA arrangements, which are more complex, many MSOs may claim to take on “full risk,” but, in reality, they only assume risk for the primary care portion of total healthcare spending. Even if your clinic performs exceptionally well, your earnings are capped because of your value-based partner’s inability to take on true “global risk” and positively impact both quality and the total cost of care.
Additionally, annual MA benefit design changes that payers make – usually in an attempt to add new members – can have a dramatic impact on your opportunity. Lack of a medical economics team to analyze the impact of these changes and work with payers to make adjustments to your program can leave both you and your value-based partner with losses instead of gains.
Great value-based care partners know how to handle the complexities of global risk agreements to help your clinic earn more (without costing you money) and they offer rolling enrollment for their value-based contracts so you don’t have to wait to get started. They also offer protection from financial downside risk and payer benefit design changes, plus expert guidance that keeps you moving in the right direction with all payers and offer programs with unlimited reward opportunity.
What To Ask:
- Do you take on partial or global risk in your MA contracts, and how will you protect my clinic from the changes payers make to benefit design?
- Is your ACO in the highest risk-reward level, “Enhanced” ACO MSSP track?
- Is rolling enrollment available for MA or Medicaid, or do I have to wait to start?
The time to decide is now.
For nearly two decades, Better Health Group has operated owned clinics and partnered with independent primary care providers to deliver better care, better outcomes, and better business results. Our top-rated primary care clinics consistently exceed CMS quality goals, reduce total cost of care, and maximize revenue across for all of your Medicare patients, a performance that places our network in the top 5% of Medicare ACOs nationwide.