Medicare is transforming into a value-based program that offers physicians and health systems three distinct reimbursement options:
- Medicare Advantage (MA) with reimbursement via agreed terms
- Medicare fee-for-service (FFS) through an accountable care organization (ACO)
- Medicare FFS coupled with the Merit-Based Incentive Payment System
However, these three payment arrangements present different opportunities and risks for providers. The challenge for providers is to determine which program presents the best financial results while affording patients the most flexible benefit options and beneficial cost-sharing arrangements. MA often presents the most favorable opportunity for providers and patients because of the following features:
利用MA的机会, providers would like to raise patient awareness of MA plan options, 包括他们自己赞助的硕士计划, as the best option given their medical condition, but are challenged in how to make the introduction in an organized fashion and in scale. A provider-initiated communication and engagement program is the answer.