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Resources 2017-05-10T12:22:38+00:00

MACRA, MIPS & MORE

MACRA – the bill known as the “doc fix” bill, or “MACRA,” which stands for Medicare Access and CHIP Reauthorization Act of 2015. MACRA repealed the Medicare Part B Sustainable Growth Rate (SGR) reimbursement formula and replaces it with a new pay-for-performance program – the Merit-Based Incentive Payment System (MIPS).  MACRA enshrines the concept of value vs. volume and a seismic shift from fee for service to value based payments.  For the years 2015-2019 physicians will receive a 5% annual medicare base reimbursement rate increase. After that time from 2020 – 2025 the medicare reimbursement rate is frozen, though through participation in two different programs there is upside potential for physicians who participate in value programs such as MIPS and Alternative Payment Models (APM’s).  ACE provides information for today’s clinicians to further understand MACRA and all its ramifications.

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FAQs

It is a physician-lead organization empowering doctors to deliver high-quality value-based care within their communities. ACE works in partnership with Managed Care Organizations to provide care coordination services directly to members, while achieving better quality results and healthcare savings that are shared with our physician partners.

First, ACE is a physician owned and operated organization designed to support the independent PCP striving to succeed in value-based care.

Secondly, ACE developed an industry-leading technology solution to sharing data seamlessly with providers, a paramount achievement in today’s myriad of health plan requirements.  We apply a proprietary algorithm to assist in identifying the most impactful clinical interventions and support the solutions with real time tracking and trending, which allows us to react immediately to emerging trends.

Thirdly, ACE applies focused care management services which is supported by our Interdisciplinary Care Team (ICT).  ACE facilitates the bi-lateral sharing of clinical data with our Providers, leading to improvements in quality outcomes, increased member engagement, cost-effectiveness and revenue maximization.

Physicians Organized Delivery System or (PODS) are groups of Physicians and Specialists geographically centered around a hospital whose members usually seek health care by providers who reside in the same geographic community, resulting in smooth transitions between providers.  ACE is divided into 5 PODS.

Submit a Letter of Interest using the “Contact Us” form or call (832) 835-5100 and speak with Provider Relations.  Your request will be reviewed, assigned to your respective POD and a member of Network Management will reach out to you.

“Here at ACE, we understand the challenges you face when accessing, coordinating and providing care and we are proud to offer you our exclusive care coordination solution; revolutionizing the way healthcare is delivered. Our goal is continued achievement of stellar performance, propelling us into the top 10% of ACOs nationwide within the next 12 months.” – Rick Click, CEO