ACO Update: Where We Are and Where We are Going

Event Information
Product Format
Prerecorded Event
60 minutes
Product Description

Seeking Approval For ACO To Participate In The Medicare Shared Savings Program? Learn From The Initial Rounds Of Approvals.

In early 2013, CMS will be approving another group of accountable care organizations (ACOs) to participate in the Medicare shared savings program, adding to the nearly 100 entities that are already selected. The MSSP awards selected groups with a portion of savings generated from more efficient care of assigned fee for service Medicare patients. As ACOs are added by Medicare and by commercial payers, nearly every provider needs to evaluate whether to participate in a shared savings organization if they are not already signed up.

For a provider group interested in pursuing ACO status, it is helpful to learn from the initial rounds of approvals. Join now for this enlightening event presented by expert speaker Wayne J. Miller, Esq.  to learn about the characteristics of successful applicants and get insights into what Medicare is seeking. At the same time, submissions by unsuccessful applicants may highlight the hurdles that need to be overcome. It is also helpful to examine how commercial ACOs come together. At the same time, ACOs that have been approved may already have some “growing pains” as they become operational. Issues such as formulas for allocating bonuses and for addressing payments for activities outside of the MSSP have to be resolved.

This audio session will discuss topics involving both the selection of ACOs and their operations.

Session will cover:

  • Attributes of Medicare and commercial ACOs.
  • Permitted participants and their obligations.
  • Keys to success or rejection by CMS.
  • Getting and keeping primary and specialist providers in ACOs.
  • Calculating MSSP and non-program bonuses.
  • What are ACO waivers and do you need them?
  • Addressing potential fraud and abuse and Stark law issues.
  • Impact of Waivers & Checklist for founders and participants
  • Structure, Management, Governing Body, Operational Minimums & Additional Operational Requirements.
  • QA/QI Program
  • Provider Obligations & Patient “Credits” to MDs
  • Sharing Options
  • Approval Process
  • F&A, Stark, CMP Waivers, Operational Issues & ACO Provider Contract Issues
  • And much more…

Who should attend? ACO participants, and hospitals, clinics, practice managers, physicians, medical groups, and health care consultants


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About Our Speaker

Wayne J. Miller - Healthcare Compliance Expert

Wayne J. Miller, Esq., is a founding partner of the Compliance Law Group, Los Angeles, a law firm focused on health care industry legal compliance for clients nationwide. Wayne has practiced healthcare business and regulatory law throughout his 30-year career. His firm represents a wide range of healthcare industry clients throughout the nation. He is a frequent speaker for The Coding Institute national teleconferences on healthcare reimbursement, transactional and regulatory...   More Info
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