The value of chiropractic patients with accountable care organizations

Chiropractors, together with other providers, can work with Accountable Care Organizations (ACOs).

These groups of primary medical care professionals provide coordinated care for Medicare patients. Accountable Care Organizations are designed to make Medicare more efficient by directing patients to receive the right services.

As a result, the goal is to reduce medical errors and unnecessary services. When the Medicare program saves funding from these programs, a portion of the savings are passed on as an incentive for ACO providers.¹

For chiropractors who are interested in working with ACOs, this represents an opportunity to generate additional revenue while also improving the care of Medicare patients. Medical providers are not required to participate in an ACO, although Medicare encourages participation and offers incentives to do so.

Primary care is the main focus of this program, so specialty care providers are not eligible. Chiropractors may not register individually as ACOs, but they are eligible to work with other types of providers such as MDs or DOs who formed an ACO as a group.²

Medicare shared savings program

This program allows Medicare providers to form new ACOs. During the annual application period, Medicare accepts new ACO applicants to the Shared Savings Program. Typically, applications are accepted early in the year for participation that begins the following year. ACOs in this program are offered a portion of the savings they generate.

From there, this incentive can be divided among participating providers in the ACO according to the contractual agreement created by the ACO’s member providers. At this point, revenue-sharing is not available to chiropractors but may be in the future.³

If you are thinking of partnering with an ACO as a contracted provider, be sure to review the contract carefully. You want to find an organization that fits your needs and respects your contribution. And you will be working with other providers to ensure your patients get the best care. Patients are free to see any Medicare provider, regardless of affiliation with an ACO, although ACO membership may generate referrals from other providers you are affiliated with.²

Participating in an ACO

By partnering with an ACO, you have an opportunity to represent chiropractors to members of other healthcare professions. ACOs typically address a range of different patient care needs, so finding an organization to partner with allows you to find more chiropractic patients.

Some MD and DO physicians may be interested in referring their patients, so you should consider ACOs as a potential source of new patients. Your work will likely encourage more providers to value the contribution chiropractic care makes to holistic patient treatment.²

You could simply form a contract with an ACO as a contracted provider or, alternatively, work as part of a group practice. As the healthcare industry grows and changes, ACOs will likely become a bigger part of Medicare. More providers are expected to join and form new organizations, making ACOs a key part of healthcare’s future.²

You can have a role within this future and show the value of chiropractic care for patients. This may just be your opportunity to shape the future of Medicare and of primary care. By becoming involved with an ACO, you are fulfilling a need and helping to give chiropractic a voice in the next phase of healthcare as Medicare seeks better coordination and greater savings.²

References

¹CMS.gov. “Accountable Care Organizations (ACO).” Centers for Medicare & Medicaid Services (CMS). https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ACO/index.html?redirect=/Aco/. Published: January 2015. Accessed: October 2016.

²Chirotexas.org. “ACOs What’s Next for DCs.” Texas Chiropractic Association. http://www.chirotexas.org/index.php?option=com_content&view=article&id=916:acos-what-s-next-for-dcs&catid=27:insurance-news&Itemid=174. Published: December 2014. Accessed: October 2016.

³CMS.gov. “How to Apply.” Centers for Medicare & Medicaid Services (CMS). https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/Application.html. Published: October 2016. Accessed: October 2016.