Overview

As Federally Qualified Health Centers (FQHCs), your commitment to providing comprehensive, high-quality healthcare to underserved communities is unparalleled. One strategic approach to furthering this mission is participating in Accountable Care Organizations (ACOs), particularly the Medicare Shared Savings Program (MSSP) ACOs. MSSP ACOs offer a unique opportunity for FQHCs to improve patient outcomes and access while controlling costs. In this blog, we’ll explore the benefits of MSSP ACOs for FQHCs and how some health centers have utilized savings to enhance patient care.

Understanding MSSP ACOs

MSSP ACOs are groups of healthcare providers and suppliers who voluntarily come together to coordinate care for Medicare patients. The goal is to deliver high-quality care while reducing unnecessary costs. FQHCs play a crucial role in these ACOs, providing essential primary care services and often serving as the patient’s medical home.

 

Benefits for FQHCs

Participating in MSSP ACOs can bring several advantages for FQHCs:

  • Improved Coordination of Care: ACOs promote collaboration among healthcare providers, leading to better-coordinated care for patients, especially those with complex health needs.
  • Financial Incentives: ACOs that meet quality and cost-saving targets can share in the savings generated, providing a financial incentive for FQHCs to participate.
  • Access to Data and Resources: ACOs provide access to valuable data and resources that can help FQHCs better understand their patient population and improve care delivery.

Utilizing Savings for Patient Benefit

Many FQHCs have used the savings generated from MSSP ACO participation to benefit their patient population in various ways:

  • Expanded Services: Some FQHCs have used savings to expand their services, hire additional staff, and implement innovative care delivery models, all of which have contributed to improved health outcomes.
  • Care Coordination Programs: Savings have been used to implement care coordination programs, ensuring that patients receive timely and appropriate care across the continuum.
  • Technology and Infrastructure: FQHCs have invested in technology and infrastructure improvements, such as electronic health records (EHRs), to enhance care delivery and patient engagement.
  • Community Outreach and Education: Savings have supported community outreach and education initiatives, helping to raise awareness about preventive care and disease management.

New ACO Primary Care Flex Model

The ACO Primary Care Flex Model (ACO PC Flex Model) is a voluntary program within the Medicare Shared Savings Program starting January 1, 2025. It aims to improve health outcomes, quality, and costs of care for underserved populations through predictable payment rates to ensure increased funding for primary care in Accountable Care Organizations (ACOs).

Key points include:¹

  • Empowerment: As an integral component of the model, ACOs and providers are enabled to employ innovative, team-based, person-centered, proactive care approaches. 
  • Quality Care: The ACO PC Flex Models aims to expand access to care, elevate the care experience, increase funding, reduce disparities, decrease program costs, and enhance incentives for ACO participation.
  • Predictable Funding: The model shifts payment for primary care through means of monthly payments and a one-time payment to ensure predictable funding for low-revenue ACOs.
  • Health Equity: It promotes health equity by increasing access to higher-quality primary care for underserved populations.

Conclusion

Participating in MSSP ACOs offers FQHCs a valuable opportunity to enhance patient care while controlling costs. By leveraging savings, FQHCs can further their mission of improving health outcomes and access for underserved communities. We encourage you to explore MSSP ACOs and discover how they can benefit your health center and patients.

 

Certintell is proud to share that we are a partner of VitaSavings,
an FQHC MSSP ACO partner for value-based care!

 

Sources:

¹ Centers for Medicare & Medicaid Services. ACO Primary Care Flex Model. CMS.gov. Retrieved April 29, 2024, from https://www.cms.gov/priorities/innovation/innovation-models/aco-primary-care-flex-model

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