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ACO Toolkit

Accountable Care Organizations (ACOs) are part of the Centers for Medicare and Medicaid’s value-based payment strategy aimed at improving quality and reducing costs.  ACOs are networks of doctors, hospitals, and other health care providers, coming together to deliver high value, coordinated care and payment for Medicare beneficiaries.  ACOs are financially incentivized to meet quality outcomes and focus on preventative and primary care. The Medicare Shared Savings Program (MSSP) is one of CMS’s largest value-based payment models.

 To assist members in navigating the ACO environment and changes, AHCA has developed a revised ACO toolkit to educate AHCA members on how Medicare ACOs work, including

  • the newest ACO models (such as Next Generation ACOs) and new regulatory requirements (such as the Pathways to Success rule), 
  • the role of SNF and PAC in ACOs, and
  • guidance on contracting between ACOs and SNFs.

The ACO Toolkit is a prerequisite to attending the live webinar on March 19th. The toolkit includes three (3) modules and two (2) pre-recorded webinars.  The first webinar combines Modules 1 and 2 and the second webinar contains Module 3. 

AHCA has launched some new items around ACOs and will be hosting an all member webinar for the member to ask questions based on the review of the materials (power points and pre-recorded webinars) of the ACO Toolkit.

If you have questions on the information or pre-recorded webinars send an email to phm@ahca.org

Speakers: Nisha Hammel, Sr Director, Population Health Management and Mike Cheek, Sr. Vice President, Reimbursement Policy

If you cannot attend, please proceed with registration as the webinar recording will be made available shortly after the live event concludes.

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Webinar: Overview of ACOs and Role of SNF & PAC [Highlights of Module 1 & 2]
Webinar 1: Overview of Accountable Care Organizations (ACOs)
Recorded 01/29/2020
Recorded 01/29/2020
Module 1 – Overview of the ACO Program
Module 1 – Overview of the ACO Program
Open to download resource.
Open to download resource. This module provides an overview of the structure, financial model and regulatory requirements of ACOS as well an understanding of how ACOs work including who can participate, beneficiary attribution, financial incentives, quality reporting and waivers.
Module 2 – Role of SNFs and PAC within ACOs
Module 2 – Role of SNFs and PAC within ACOs
Open to download resource.
Open to download resource. Building on Module 1, Module 2 provides a more detailed understanding of the role and opportunity for SNFs and PAC in the ACO model.
Webinar: Overview ACOs & SNF Contracting [Module 3]
Webinar 2: Contracting with ACO's
Recorded 01/29/2020
Recorded 01/29/2020
Module 3 – ACO-SNF Contracting Guide
Module 3 – ACO-SNF Contracting Guide
Open to download resource.
Open to download resource. Module 3 highlights the key components in the development and negotiation of contracts between SNFs and ACOs including the key components of a contract, recommendations on terms that should (or should not) be in the contract, and important considerations for contract negotiation. The additional three documents provide a more detailed understanding of the contracting guidelines and requirements around ACOs and SNFs.
Part 1: Background on Guide and ACO Primer
Open to download resource.
Open to download resource. Document provides information on how to use the guide and ACO primer that accompanies a Model Agreement (Part III) that is intended to provide information for skilled nursing facilities (SNFs) about the issues to consider in contracting with a Medicare-qualified accountable care organization (ACO) as an ACO “participant”, “other entity” or “preferred provider”.
Part 2: Preparing for and Contracting with ACOs
Open to download resource.
Open to download resource. The document offers insights into the due diligence process that the SNF should undertake before commencing negotiations, and preparation of strategic material
Part 3: Model Contract Terms
Open to download resource.
Open to download resource. Provides a template for consideration around contract terms for participation in the Medicare Shared Savings Program.
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