New Payment Model Coming to Arkansas

December 2, 2020

Yesterday, Aledade announced that we are forming the first primary care physician-led accountable care organization (ACO) in Arkansas. We are proud to bring independent doctors in Arkansas a new model of primary care that will allow them to stay independent, focus on delivering high-quality care, and be rewarded for keeping patients healthy.

ACOs are part of a significant transformation in health care to value-based care – care in which doctors are reimbursed not for the number of tests or procedures they undertake, but in how successful they are in managing the health of their patients. In Arkansas, practices in the Aledade ACO will benefit from Aledade’s regulatory expertise, best practices from our nationwide network of primary care doctors, technology and data analytics, and in-person practice transformation support.

However, ACOs are not the only way for Arkansas doctors to participate in value-based care.

Earlier this year, the Centers for Medicare and Medicaid Services (CMS) announced a massive new pilot program called Comprehensive Primary Care Plus (CPC+). CPC+ is designed to help practices build capabilities and care processes to deliver better care by offering them greater financial resources and flexibility in care delivery. The goal of CPC+ is to strengthen primary care to enhance the quality of care patients receive, improve patients’ health, and spend health care dollars more wisely.

CPC+ does this by paying physicians monthly care management fees tiered to the patient’s level of need; different from the current “one-size fits all” Chronic Care Management fee that practices have been using to support comprehensive patient care. These payments provide physician practices with much-needed resources to invest in the capabilities and tools to effectively manage population health and the total cost of care.

The good news is that, as Aledade had hoped and proposed to CMS, CPC+ is open to physician practices that are also participating in the MSSP ACO program. Furthermore, CMS recently named Arkansas one of the regions in which CPC+ is being implemented. Together, this means that practices in the state can participate in both CPC+ and the Aledade ACO. The unique combination of CPC+ and the ACO gives both the resources necessary to improve patient care and the incentives to reduce the total cost of care. Upfront care management fees and support with the ACO’s primary care-led efforts to generate shared savings offers great promise in the goal of improving care quality and lowering costs. For physician practices, this means getting the upfront financial resources and support to improve care access, care management and coordination, and patient engagement, while also being rewarded for the resulting improved health outcomes through ACO shared savings payments.

Aledade will help its partner practices in CPC+ work to fulfill the program’s practice, reporting, and care management requirements, much of which align with the efforts Aledade practices are already doing as part of an ACO. Aledade also will continue to monitor what comes out of Washington so that its doctors can understand, adapt, and thrive under whatever new rules or programs are introduced.

A lot is changing in health care delivery, and Arkansas is no exception. With these models and with the right partners, I am confident it will mean better health care for Arkansans and thriving practices for their doctors.