Payment Models & Accountability
The MAFP’s partner ACO, Aledade, hosts workgroups of primary care physicians at the MAFP office several times annually. The group meets by webcast with other groups around the state to compare notes about how to improve patient care and break down barriers.
Aledade is an Accountable Care Organization with 143 partner physicians in its Mississippi/Tennessee organization. All told, Aledade has 1,200 providers in 15 states. Meetings like the one last week bring together a network of like-minded physicians who strive for value-driven care. These workgroups discuss varied topics ranging from ‘Transitions of Care’ to ‘Evidence-Based Medicine.’ MAFP partnered with Aledade in 2015. For more information, contact Blaine Lindsey, Executive Director and Chair Aledade Mississippi ACO LLC at 504-982-0379.
Here are benefits of membership in Aledade:
– Aledade’s specialists visit each member practice’s office to help staff members improve workflows, generate savings and realize revenue
– Aledade provides each practice with a list of high-risk patients coming to the office that day, giving the staff members time to consider how best to serve each vulnerable patient
– Aledade offers webinars to educate staff members on legislative and policy changes that affect each practice on a daily basis
– Aledade’s cloud-based software integrates into EHRs and workflows. Its platform also gives members insight into local ADT feeds to allow for proactive support to local people who need it most.
Direct Primary Care
In 2015, the Mississippi Academy of Family Physicians worked with members of the legislature and the Governor to ensure the passage of the “Mississippi Direct Primary Care Act.” At that time, there were only 7 other states in the nation to provide laws regarding a DPC agreement.
Direct Primary Care gives doctors more freedom with patients to practice medicine instead of being tied to insurance requirements. With the MAFP championing the DPC movement in Mississippi, we have ensured that DPC agreements cannot be viewed as insurance policies. If you are considering moving to a DPC agreement with your patients, make sure your contracts mirror the state law. All of the following requirements must be met:
- Be in writing;
- Be signed by the individual patient or his or her legal representative and be made available for the records of the primary care provider or agent of the primary care provider;
- Allow either party to terminate the agreement on written notice to the other party;
- Describe the scope of the primary care services that are covered by the periodic fee;
- Specify the periodic fee for ongoing care under the agreement;
- Specify the duration of the agreement, any automatic renewal periods, and require that no more than twelve (12) months of the periodic fee be paid in advance. Upon discontinuing the agreement all unearned funds, as determined by the lesser of normal undiscounted fee-for-service charges that would have been billed in place of the agreement or the remainder of the membership contract, are returned to the patient; and
- Prominently state in writing that the agreement is not health insurance.
The MAFP is supportive of legislation at the federal level that would clarify that a DPC is not health insurance. Federal lawmakers are aware of the growing interest in the direct primary care model and have introduced legislation. AAFP story on legislation in Congress.
If you’re considering a position as an employee of a hospital, health system, or physician group, it’s important to know the basics before you negotiate an employment agreement. A health care transactional attorney can help you review a specific employment agreement in detail to be sure it is fair, appropriate and represents your best interests. More information from AAFP