July 12, 2024
We’ve been busy at Aledade, diving into the details of the PC Flex program, and having clarifying conversations with CMS. We analyzed every ACO for Flex and have identified three groups of ACOs, each with a distinct path in front of them.
ACOs who are starting a new MSSP contract anyway for 2025
This group has the most time to consider Flex. We will keep the Flex evaluation going and communicate with you and your ACO leaders throughout August and September leading up to the Oct 17th application date for Flex. If you are unsure whether your MSSP contract is starting a new contract in 2025, please reach out to your ACO’s Aledade leadership team.
ACOs with a good savings rate and years left on their current MSSP contract
This group is a poor candidate for Flex. Flex requires an ACO to start a new MSSP contract which means an early ratchet to savings. Starting a new MSSP contract under Flex would lead to significant financial losses.
Practices new to MSSP
It is natural to want to include as much information about Flex in making that decision before the August 1st deadline to join MSSP. To support those practices and to get a headstart for existing practices we have designed a payment model based on extensive input from practices.
Beyond just simplification, we added two additional principles to the Aledade Flex payment model not present in CMS’s model:
- Ensure a practice in Flex will never have less revenue for primary care than they would have had they not joined Flex
- Payments vary with the intensity of the patient’s needs in any given month.
To meet these principles, we turned to a familiar base. Aledade will continue to pay fee-for-service at full Medicare rates summed up in a monthly payment to ensure both principles. In addition, we will separately distribute enhanced payments to practices based on the number of annual wellness and transitional care visits performed by each practice.
Why focus on these visits? Well, our decade-long experience with ACOs has shown us that these visits have the most significant impact on generating savings and providing higher quality care for beneficiaries.
Aledade has the experience to operationalize Flex in ways that maximize your ACO’s long-term success. We will make sure you are in the right model for your practice. Schedule a meeting with an expert today.