Risk Strategies helps ACOs protect themselves from the downside risk of value-based contracts. We also help ACOs and their members reduce expenses with market-leading insurance products so they can focus on the triple aim of improving patient care, improving population health and reducing health care costs.
Risk Strategies is a privately held, national brokerage and consulting firm. Ranked in the top 20 brokers in the country, we offer risk management advice and insurance and reinsurance placement for health care, property and casualty, and employee-benefits risks.
We have one of the largest teams of dedicated health care insurance and reinsurance professionals operating across the country and we bring to our health care clients a focused, integrated and responsive liability and risk management service that is best-in-class.
With offices across the country, Risk Strategies gives you the reach and resources of a nationwide firm with the focused expertise and attention of a boutique specialist.
Protecting ACO Downside Risk
Managing the overall financial impact of risk-based contracts is vital for providers to ensure the long-term financial success of their organizations as a whole. Insurance plays a key role in protecting against the downside financial impact of risk-based contracts and two types of insurance in particular can play a role:
Specific stop-loss insurance that protects the provider from the financial risk associated with high dollar claims for individual members in their risk population
Aggregate stop-loss insurance that protects the provider from the overall performance of a given risk-based contract
We are experts in protecting ACOs’ downside risk.
Medicare Shared Savings Program (“MSSP”) Track 1+, Track 2 and Track 3; Pathways to Success Tracks C, D, E, and Enhanced; and NextGen ACOs, have two-sided risk. CMS requires these ACOs to provide a repayment mechanism to assure that shared losses can be repaid.
Depending on its track, a Pathways to Success ACO’s repayment mechanism equals the lesser of either: 2% of the total Medicare Parts A and B FFS revenue of its ACO participants or 1% of the total per capita Medicare Parts A and B FFS expenditures for its assigned beneficiaries.
CMS accepts letters of credit (LOC), cash held in escrow, and/or surety bonds for this purpose. While LOCs are an acceptable form of collateral, LOCs are costly and inflexible, and ACOs often struggle to find the capital to place into escrow funds. The better, more cost-effective option for ACOs is using a surety bond.
We advise on, and place, surety bonds for our ACO clients.
Medical malpractice insurance is one of the largest expense categories for health care providers. An ACO that offers a proprietary Medical Malpractice program for its members brings added value to the ACO relationship.
We specialize in medical malpractice insurance for physicians and surgeons and we can create an exclusive insurance program for the members of your ACO with an AM Best “A” rated carrier which could cut insurance costs by 20% to 40%.
A Full Spectrum of Coverage
Go beyond the limits of a generalized broker. The focused expertise of insurance professionals from Risk Strategies ensures you get innovative, practical approaches to the full spectrum of liability and risk your business faces, including:
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We are confident that we have a risk solution that will meet your needs. To discuss the options available to protect every facet of your ACO’s risk, please contact: Chuck Newton at firstname.lastname@example.org or 804.647.8360 or visit www.risk-strategies.com/healthcare