CMS Announcement of 106 New ACOs Could Lead to Bright Future for Solo FP

CMS' recent announcement acknowledging the establishment of 106 new accountable care organizations (ACOs) available to serve Medicare patients was especially sweet news for one solo family physician located in tiny Spring Hill, Kan., a rural community just south of the Kansas City metropolitan area.

The new batch of ACOs announced by CMS dot the U.S. map, stretching from coast to coast. They include sites in California, Florida, Connecticut, Oregon and states in between. According to a Jan. 10 press release from CMS, roughly half of the new ACOs (36-page PDF; About PDFs) are physician-led organizations and serve fewer than 10,000 Medicare patients each.

One of those new ACOs is the Kansas City Metropolitan Physician Association ACO (KCMPA-ACO), which was the first Medicare ACO in the Kansas City area and which includes 40 primary care physicians who provide health care to about 12,000 Medicare patients.

Jerad Widman, M.D., of Spring Hill Family Medicine, along with 12 others, is a founding member of the KCMPA-ACO. He was delighted to find out that his ACO was accepted into both the CMS Shared Savings Program and the Center for Medicare and Medicaid Innovation Center's Advance Payment ACO Model program.

CMS made the ACO announcement the same day as the KCMPA's monthly meeting, according to Widman. "I first heard about it from our president that night -- an exciting moment of victory for all of us," he said.

Just last fall, Widman was skeptical that he could maintain his high-level patient-centered medical home practice, because although he had invested a significant amount of time and money in making changes in his eight-year old practice, he had yet to receive much in the way of enhanced payments.

The recent news from CMS could change that.

According to Widman, the advance payment will allow him to access a larger system of care coordination via the KCMPA-ACO that will provide data, expertise and staff for his practice. "That, in turn, allows for improved population management," he said.

Specifically, Widman looks forward to having the opportunity to sift through statistical data so that he can identify his own practice patterns, including emergency room use and specialty referrals that affect the cost and quality of the health care he provides his patients.

"If, based on the data, I am able to improve the cost of care provided to my patients, while maintaining or improving the quality of that care, I will qualify, as a participant in the KCMPA-ACO, to benefit from the shared savings aspect of that program," said Widman.

A true financial boost to Widman's practice likely is 18-24 months away, but he's eager for the changes that are coming. "I am quite optimistic that I'm going to be rewarded in a manner that facilitates the quality-driven care (as opposed to volume-driven care) that I've been committed to providing since opening my practice eight years ago," he said.

Organizations interested in participating in the Medicare Shared Savings Program launching in January 2014 should begin preparing for the application period, which opens during the summer of 2013.