IT Spending Guide: Place Your Bets
ICP employs six physician practice liaisons, each of which carries an average load of 80 practices each. MSSP reporting takes place once a year, but MA reporting imposes a burden on these liaisons throughout the entire year, he says.
In addition, ICP pays care management fees to its primary care offices to help shoulder the reporting burden.
"We ask a lot of our primary care offices: Every month there's some data collection, reporting, or patient review analysis," Thompson says. "It is a burden on them, so to help offset that we pay them $5 per commercial patient per month, and $10 for a Medicare patient, in what we call care management fees. We calculate it monthly and we pay it out quarterly, and that really helps with the engagement and some of the pushback when a practice says, ‘Oh, I don't have time to do this.'
"We explain that care management fees are provided to help with the extra burden. Usually when they realize that, and that they're getting, in some cases, some reasonably considerable extra income, it helps with all the extra stuff we're asking them to do."
These care management fees apply to a wide range of programs beyond MSSP and MA, including efforts to identify frequent-flyer emergency room patients, as well as new or emerging quality initiatives, he says.
Now that ICP has been identified as a Track 2 advanced payment model MSSP for 2018 under MACRA, these practices will be individually responsible for continuing to demonstrate their use of advancing care information, the successor to meaningful use, Thompson says.
Otherwise, ICP continues to shoulder the reporting burdens as before.
"We actually got into the ACO expecting that we wouldn't do well, because Arizona is one of the lowest Medicare cost states in the country already," Thompson says. "We didn't think there was a lot of opportunity to squeeze out cost, but we are pleasantly surprised that our business model works and, in our first year, we earned something."
Other ACOs may spend more or less than ICP did to achieve similar outcomes, depending on the technology selected, configuration, upgrades, and support needed, along with several other variables unique to that organization's business model and projected growth plans, Thompson adds.