ACO Frequently Asked Questions

Can I participate in more than one ACO?

A primary care doctor can only participate in one ACO. A specialist can belong to as many ACO’s as they would like; However, if a specialist has attributed lives based on CMS assignment methodology, they can only belong to one ACO.

Do I still bill Medicare for my patient encounters?

Absolutely. You continue to bill CMS (Medicare) through your individual Tax ID number and collect the money into your personal practice.

So what is the advantage of participating in your ACO?

As a physician participating in PremierMD ACO, you will be able to contribute to achieving the three objectives of the Medicare Shared Savings Program: (a) Quality outcomes, (b) Lower costs and (c) Improved patient satisfaction. Additionally, PremierMD will distribute 70% of the net shared savings back to its participating physicians. At PremierMD, we have no cost or fee to participate, a 45 day out clause, no requirement for a uniform EMR and no increased overhead costs that are associated with a hospital affiliation which could impair the ability of our ACO to generate shared savings for our participants.

Who can participate in the ACO?

Any physician, both primary care and specialist, can be a part of our ACO.

How will the ACO be governed?

There is a governing board of member doctors who will act in the best interest of the ACO and its members. The board is a rotating position such that any physician wishing to participate may elect to do so, if selected. There is no compensation for this role. For a more complete description of the governance and committees, please click here

Is there a restrictive covenant for participating or leaving?

No

For additional information about Shared Savings, visit:
https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/index.html
For general questions or additional information about Accountable Care Organizations, please visit www.medicare.gov/acos.html or call 1-800-MEDICARE (1-800-633-4227) TTY users should call 1-877-486-2048.

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