Estimated claims-aligned Medicare patientsAll offers last sourced at EST on , . Offers are generated based on current information we have about your practice. Payments made in Performance Year 2023 will be based on practice performance and final data from CMS and are subject to change.
Help us understand a bit more about your practice, your payment preferences, and risk tolerance.
Available offers that are best aligned for you will appear here. See an example with 400 original Medicare patients below.
Our system requires a bit more information about you so we can ensure we’re providing the best offer for you.
Steady Revenue
$9,781 per year
Capitation Payment
$679 / month
Approximate FFS Payment
$0 / month
Pearl Revenue Enhancement*
$136 / month
Performance-Based Payments
$2,300 per year
Potential Shared Savings**
$2,300 per year
Payments 1 ? Transitioning to 100% capitation for original Medicare gives you revenue stability and positions you to make the most of Shared Savings.
Capitation %
20%
Fee-for-Service (FFS) %
80%
Revenue Enhancement %
40%
Risks 2 ? With this option, you take on zero downside risk, which allows you to test your way into the model with peace of mind. Once you’re accustomed to ACO REACH, you can always decide to take on more risk in future years to maximize your Shared Savings.
Upside Share
50%
Downside Share
50%
* Pearl Revenue Enhancement of 40% available only through July 15, 2023. Learn more.
** Shared Savings reflects upside after accounting for Professional ACO REACH risk corridors; Financial performance above is illustrative; Actual payments will be a result of practice performance during the performance year
| 2024 | 2025 | 2026 | |
|---|---|---|---|
| Steady Revenue | $9,781 | $8,953 | $8,149 |
| Capitation Payment | $679 / month | $679 / month | $679 / month |
| Approximate FFS Payment | $0 / month | $0 / month | $0 / month |
| Pearl Revenue Enhancement* | $136 / month | $67 / month | $0 / month |
| Performance-Based Payments | $2,300 | $2,300 | $2,300 |
| Potential Shared Savings** | $2,300 | $2,300 | $2,300 |
| Payments 1 ? Transitioning to 100% capitation for original Medicare gives you revenue stability and positions you to make the most of Shared Savings. | |||
| Capitation % | 20% | 100% | 100% |
| Fee-for-Service (FFS) % | 80% | 0% | 0% |
| Revenue Enhancement % | 20% | 15% | 0% |
| Risks 2 ?This arrangement does expose you to some downside risk. However, Pearl limits your exposure by taking on asymmetric risk on your behalf, while offering you much more of the upside share. If you believe you will perform well in this model, this is the best option to maximize your Shared Savings. | |||
| Upside Share | 25% | 35% | 50% |
| Downside Share | 0% | 10% | 50% |
* Pearl Revenue Enhancement of 40% available only through July 15, 2023. Learn more.
** Shared Savings reflects upside after accounting for Professional ACO REACH risk corridors; Financial performance above is illustrative; Actual payments will be a result of practice performance during the performance year
1 Steady revenue payments do not include revenue from non-PQEM codes billed. Non-PQEM codes will continue to be billed FFS at the same rates as your practice is billing today.
2 Risk shares calculated after accounting for ACO REACH risk corridors.
Loading ...
