Member Benefits

America’s MDE, has previously generated substantial shared savings through its MSSP Accountable Care Organization. There are numerous benefits to participating in a network with an MDE. As an Advanced Payment Model (APM), there is no MIPS/MACRA penalty and the administrative burden is significantly reduced. Additionally, there is an automatic 5% APM incentive bonus which is paid directly as an annual lump sum payment to your practice from CMS. 

Participation in America’s MDE is accompanied by increased reimbursement, as you will receive a minimum of 110% of the Medicare allowable for all evaluation and management services. There are beneficiary enhancements and waivers for patients as well. While there is an opportunity for shared savings, as there is in an ACO, America’s MDE is offering participation in shared savings with no downside risk.

ENHANCED COMPENSATION – Until now, monthly capitation payments for Medicare beneficiaries were only paid to doctors for their patients enrolled in managed care plans. But now, with America’s MDE, you can receive capitation payments every month for your patients with traditional Medicare. Our MDE will help participating doctors reduce overall healthcare costs, improve outcomes, and increase options for their patients.

NO FINANCIAL RISK – CMS pays a monthly capitation fee to America’s MDE, and in turn, we’re responsible for delivering the full scope of patient care at full financial risk. 

QUALITY REPORTING IS ELIMINATED – Providers are exempt from MIPS reporting requirements. 

NO NARROW NETWORKS – Patients can visit any doctor, hospital, or other healthcare provider that accepts Medicare.

GROUP DISCOUNTS – Enhanced ability to negotiate favorable contracts with other entities such as radiology, laboratory, and hospital systems

5% APM INCENTIVE BONUS – An Alternative Payment Model (APM) is a payment approach that gives added incentive payments to provide high-quality and cost-efficient care. APMs can apply to a specific clinical condition, a care episode, or a population.

MAINTAIN INDEPENDENCE – There is no revamping of your current corporate structure. You maintain complete independence and autonomy while enjoying the benefits of being part of a network.

COLLEAGUE COLLABORATION – Provides you with the opportunity to network with physicians in multiple specialties. Make new relationships and expand upon current ones.

PREPARATION FOR CHANGES/REFORM – With ever changing healthcare, America’s MDE can prepare and educate your practice on any and all upcoming changes and initiatives. Together we can position ourselves to be ready for the impending reforms in payment methodology in healthcare.

OPERATIONAL EFFECTIVENESS – America’s MDE can provide resources and tools necessary to help your practice grow and enable exceptional care.

CLINICAL EXCELLENCE – We can assist in delivering a model that will provide consistent clinical care in an integrated way.

 

Additional Benefits

Additional benefits to participating in America’s MDE:

  • Financial incentives
  • Efficient practice administration and management
  • Political influence with the medical community
  • Peer support
  • Optimized facilities
  • Enhanced ability to negotiate favorable contracts with other entities such as radiology, laboratory, and hospital systems
  • Autonomy and local financial / care management control in managed care
  • Improved services, including, expanded hours, urgent care, outreach services for prevention, telephone triage, and follow-up expertise.

Take the first step.

Open enrollment for Plan Year 2022 runs now through early September.  We invite you to email our executive Mark Bobango at MBobango@SCIPALLC.com.