ACO

We believe value-based care can work for all of us. Joining an ACO opens up new benefits for your Medicare patients and new financial opportunities for you.

The First Step Is Finding The Right Partner

Someone who has done all the regulatory homework and understands the financial levers. Someone with a strong population health playbook, and big-hearted care coordinators who connect with patients outside of the practice. And most importantly, someone who understands your practice and provides solutions built around your priorities. More than 2,000 providers have already partnered with NeueHealth. Join us!

The NeueHealth Approach

We bring an individual approach to each partnership to bring the possible to life. Whether you’re considering your first ACO or your fourth, we have a suite of services to enhance your capabilities and improve your performance. For all partners, we bring competitive financial terms, a team of best-in-class care managers, and actionable dashboards.

Doctor talking with a patient.
NeueHealth partners with groups, practices, and clinics of all sizes, in rural and urban communities—with extra heart for small practices and federally qualified health centers and community health centers.
Our partnerships are flexible. If a one- or two-year commitment is what makes sense for your practice, we’re all for it.

Doctor explaining oxygen monitoring to patient.

Surround your patients with care

Our Care Coordinators serve as an extension of your team, connecting with patients beyond the doors of your practice to provide whole-person, whole-hearted care. Care Coordinators virtually integrate into your practice at no cost to you or your patients, with a focus on:

• Care at home, including telehealth and home visits (based on eligibility)
‍
• Transitions of care, starting during a hospitalization and continuing at home
‍
• Social care needs, from basic needs like food, shelter, and financial assistance to counseling, weight management, and caregiver support

Get rewarded for doing the right thing

 

Partnering with NeueHealth allows your practice to share in ACO savings based on performance and other financial arrangements, helping you benefit from improved care outcomes and cost efficiency.

Doctor reading notes to patient.

Public Reporting

Review public reporting information online
NeueHealth Premier ACO (CA, FL, TX)
NeueHealth Advantage ACO (FL, IL, SC)
NeueHealth Collaborative Care (CA, FL, SC)
NeueHealth Community ACO (CA, IN, MI, OH, TX)
As part of our participation, the ACOs have signed a Participation Agreement with CMS.

The ACO REACH PY2024 Model Participation Agreement is available here.

Beneficiary FAQ

  • ACO stands for Accountable Care Organization.
  • An ACO is a group of doctors and healthcare providers who work together to provide quality care to Medicare patients. ACO providers focus on care coordination, preventative care, and disease management to keep patients healthy.
  • ACOs are designed to put patients at the center of their care and help them navigate a complex health system.
  • We believe this coordination will allow us to provide better care to our patients.
  • Patients are encouraged to visit the Medicare website to learn more:
    https://innovation.cms.gov/key-concepts/accountable-care
  • Only traditional Medicare patients are eligible to join an ACO.
  • Most of our Medicare patients are enrolled in the ACO by Medicare.
  • Medicare patients who are not enrolled can choose to join by signing a form at participating doctors offices or online at Medicare.gov to indicate the doctor they receive their primary care from. That form is called a Voluntary Alignment form.
  • Patients in an ACO may receive additional services – like care management home visits – or may receive better coordinated care because their providers are working together
  • Beneficiaries in an ACO keep all traditional Medicare benefits. They can continue to see any doctor or hospital they choose.
  • Voluntary Alignment is the process by which a Medicare beneficiary signs a form at a participating doctor’s office or on Medicare.gov to indicate their primary provider and join an ACO.
  • Medicare designed this process to empower beneficiaries to be more active in their care.
  • After a beneficiary signs the form, the provider submits it to Medicare for review. Voluntary alignments completed online at Medicare.gov are submitted to CMS automatically.
  • Voluntary Alignment is not effective right away. New beneficiaries are added at the start of the quarter – for example, April 1 or July 1.
  • This is completely voluntary. The beneficiary is still free to receive services from any provider of their choice, whether or not they are a part of the ACO.
  • Beneficiaries can take the form home and return it at a later date if they would like to think about it.
  • The beneficiary needs to complete all fields on the form and do so independently. The Health Center staff cannot complete any section on behalf of a beneficiary.
  • The beneficiary can use a legal representative to complete the form, but it must be documented that the representative is legally able to complete the task on the beneficiary’s behalf.
  • Health Center staff can help the beneficiary find their Medicare number, but the beneficiary needs to write the number on the form themselves.
  • If a beneficiary is unable to sign the SVA form due to physical limitations and the beneficiary has no appointed legal representative, it is appropriate for the beneficiary to sign using a mark on the page (such as a thumb print or written symbol). However, a witness must be present to sign their own name and address next to the mark, attesting to the beneficiary’s intention to sign. This witness should be a person independent of the doctor’s office (e.g. a friend or family member).
  • You can also designate your primary clinician by visiting Medicare.gov.

Provider FAQ

The Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model is a value-based payment model introduced by the Center for Medicare and Medicaid Innovation (Innovation Center) to help reduce the total cost of care and enhance quality specifically for Fee-For-Service (FFS) Medicare patients. The ACO REACH model began on January 1, 2023.

The ACO REACH Model will replace the Direct Contracting model – also known as the Global & Professional Direct Contracting (GPDC) Model – in 2023. The transition to ACO REACH from Direct Contracting marks a move to greater emphasis on health equity, provider-led organizations, and protections for beneficiaries. The fundamentals of how the model itself works will remain the same. As an approved Direct Contracting Entity (DCE), NeueHealth’s participation will continue in ACO REACH.

Medicare beneficiaries – including beneficiaries in underserved communities – can expect to see improved coordination of their care because their provider is participating in this model. ACO REACH makes it easier for providers to work together to improve health outcomes for their patients. The program is expected to improve beneficiary experience by making care more accessible, promoting preventive care, and reducing duplicate tests and procedures. Beneficiaries may also be eligible for additional benefits and incentives (including a gift card) through the model. Beneficiaries included in the model keep all of their rights, coverage, and benefits, including the freedom to see any Medicare-enrolled provider they want.

CMS will align beneficiaries to the Participant Provider from whom they receive most of their primary care. The beneficiary must have had an encounter with the provider in the past two years, live in the service area, and be enrolled in Medicare Part A and Part B. This is known as claims-based alignment. Beneficiaries may also self-select the REACH ACO by completing a Voluntary Alignment Form designating one of the Participant Providers as their main source of care.

For performance year 2023, Participant Providers in the REACH ACO may be eligible to receive a 5% Advanced APM incentive payment from CMS and be exempt from the Merit-Based Incentive Payment System (MIPS).

No. A Participant Provider may only participate in one APM, such as a REACH ACO or MSSP. However, a Participant Provider may be a Preferred Provider in another APM.

NeueHealth has contracted with providers in California, Florida, Illinois, Indiana, Michigan, Missouri, and Ohio. We are interested in growing these geographies, and others, with the right partners!

Learn More About How NeueHealth Drives Value.

Contact Us
NeueHealth Logo

Careers

Compliance

Suppliers

Terms of Use

Privacy Policy

Accessibility Statement

Blog

LinkedIn

8000 Norman Center Drive, Suite 900, Minneapolis, MN 55437

NeueHealth © 2024