Physicians group gets approval on Medicare ACO

Recent trends of hospitals and insurance groups forming coordinated care organizations has encouraged four physician groups to come together to uphold independence while being able to take part in a Medicare Plan shared savings program.

Optimus Healthcare Partners LLC is a Summit-based accountable-care organization created by four independent practice associations in January 2011, representing more than 500 physicians through north and central New Jersey. It was one of 27 ACOs in the United States recently recognized to partake in the Medicare Plan shared savings program, where savings from reduced patient readmissions and duplicative services will be split with the care providers.

Dr. Thomas Kloos, president and CEO of Optimus, held that the practices concerned are made up of roughly 110 primary care physicians and family doctors, 60 pediatricians and other specialists. While there is no set description for an ACO, in many cases, care providers work in teams to manage the medical care of thousands of patients, with the mission of delivering better health at a lower cost.

Kloos also remarked that Optimus decided to “be agnostic in the marketplace” and not join a hospital ACO or in an association made up of private insurance groups, like Cigna or Horizon Blue Cross Blue Shield, so as to maintain independence in managing practices and to have similar procedures across all patients, irrespective of insurance carrier. This permits Optimus to participate in Medicare’s program while still having contracts with other payers.

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