2020 ACO Distribution | November 2021 | Newsflash


November 15, 2021


MHPN to distribute $2.5 million to ACO providers

 

McLaren High Performance Network, LLC (MHPN) is pleased to announce the release of the provider distribution of the 2020 ACO shared savings to our ACO member providers. The payout will consist of utilizing the Board approved methodologies for Clinical Integration payments based on McLaren Physician Partners (MPP) CI scorecard performance of participating physicians on related metrics and Medicare Beneficiary Attribution.

The total distribution amount is $4,779,012 with $2,479,012 distributed to providers.

Independent PCP and Specialist payments will be made to the current Tax ID on file.

MMG (employed) PCP and Specialist payments will be forwarded to MMG. MMG will distribute in accordance with the MMG physician compensation model.

Improving performance on the following measures will increase your clinical and utilization performance which may result in an increased financial distribution.

  1. Transitions of Care visits (TOC/TCM):
  • A visit to the PCP within 7-days of discharge, remains critical to the coordination of care a patient must receive to support a patient’s return to health and to help reduce unnecessary utilization, readmissions and spend during this critical recovery period.

  • HCC Coding:

 

  • Proper HCC coding by our providers to more accurately document and code a beneficiary’s medical conditions funds the severity of care the patient needs by CMS to the ACO.
  • This helps to increase the benchmark target amounts set by CMS against which our performance is measured.

 

 

  1. Care Coordination:
    • Management of the chronic medical conditions of the high need/high-cost patients.
    • Providing outreach and management to those patients with stable chronic conditions before an acute episode occurs.
    • Refer patients to the MPP Care Coordination team.
  2. Annual Wellness Visits (AWV):
    • These visits are a great opportunity for a health care provider to assess a beneficiary’s risk and provide self-management education.
    • Providing an AWV plays a key role in beneficiary assignment to our ACO, as this may be the only Primary Care visit a healthy Medicare Beneficiary has in a calendar year.
    • MHPN can provide a list of your prospective Medicare members who are eligible for an AWV.

 

The MSSP ACO contract is our largest value-based contract at McLaren. Fee schedules for many payers are frozen, similarly, CMS has no physician fee schedule increases planned for the foreseeable future in the MIPS program. Value-Based Payments from Value-Based Contracts like these will continue to be the way physicians, hospitals and health systems receive additional funding going forward.

For more information or to discuss joining our ACO please contact me at michael.ziccardi@mclaren.org or (248) 484-4923.