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For nearly two decades, Better Health Group has been a leader in value-based care and operating top-rated primary care clinics. Our network of owned and independent clinics leverage our model to improve care for both Medicare Advantage (MA) and Traditional Medicare patients. Now, the Centers for Medicare & Medicaid Services (CMS) has ranked Better Health Group in the top 5% of Medicare Shared Savings Program (MSSP), Accountable Care Organizations (ACOs) for performance year 2023.
At a time when independent clinics face mounting challenges, our providers are exceeding CMS quality goals and maximizing shared savings revenue, in every state in which we operate—Florida, Alabama, Georgia, Texas, Oklahoma, and Tennessee.
Providers and their value-based partners face mounting pressure from 2025 reimbursement changes.
With the CMS 2025 Medicare Physician Fee Schedule declining by nearly 3% and the continued expansion of the V28 coding model, clinics are facing reduced revenue compared to 2024. "V28" significantly impacts providers who accept Medicare and Medicare Advantage, forcing them to focus on more complete coding and care management for certain conditions.
Likewise, ACOs, Independent Physician Associations (IPAs), and Managed Service Organizations (MSOs), that contract with payors and assume risk on behalf of their network of clinics, also face pressure, exposing providers in their networks to decreased shared savings potential. Many value-based provider organizations that were successful now find it harder to meet performance, forcing many to limit the acceptance of new clinics into their payer contracts.
Independent clinics near a tipping point: lose revenue or find a partner who can help improve quality and efficiency — and bear risk across all payors.
At Better Health Group, we don’t just run a Medicare ACO and a Medicare Advantage MSO, we’re a peer in the clinical community and we know running a successful practice in today’s environment is hard. Reduced reimbursement rates, added documentation requirements, workforce shortages, and supporting multiple value-based contracting partners are forcing clinics to spend less time with more patients.
Clinics using our model practice better medicine, spend 47% more time with their patients, see nearly one-third fewer patients, and achieve top-tier HEDIS and Star Ratings. While clinics using a traditional fee-for-service model or an underperforming value-based care partner would suffer financially, our clinics are running better businesses, with average gains of over $1,000 per patient, per year and a highly engaged clinical team (94%+).
Mike Polen, CEO of Better Health Group, summarizes it best:
“While I’m proud of our ACO results, I’m even more proud of how we’re transforming independent practices. With the recent changes to Medicare, it’s a tough time for all of us who run primary care clinics. Our model provides the support and information providers and their staff need. We give them more time to spend with their patients, leading to higher-quality care, at a lower cost for everyone. And with our ability to take on more risk for a greater reward than most ACOs and MSOs, our network of providers get to keep more of the financial value they create.”
Choose your ACO wisely. Go beyond MSSP and REACH. Know your options.
If you’re selecting an ACO partner, based only on their shared savings or monthly REACH payments, you are most likely not achieving maximum value. Before you enroll in MSSP or Reach for 2026, or sign a longer-term Medicare Advantage contract, ask these 5 questions:
- What were your most recent ACO and MA performance results?
- What tools and staffing will you provide, in and out of my clinic, to help adopt value-based care and improve my coding accuracy?
- How soon will my clinic see revenue increases or shared savings bonuses?
- For my MA contracts, how will the 2025 benefit designs impact my shared savings?
- Can my shared savings be reduced due to other low-performing clinics in your network?
Free Report: See your clinic’s missed revenue opportunities and what your ACO is costing you.
Providers and their value-based partners face mounting pressure from 2025 reimbursement changes.
With the CMS 2025 Medicare Physician Fee Schedule declining by nearly 3% and the continued expansion of the V28 coding model, clinics are facing reduced revenue compared to 2024. "V28" significantly impacts providers who accept Medicare and Medicare Advantage, forcing them to focus on more complete coding and care management for certain conditions.
Likewise, ACOs, Independent Physician Associations (IPAs), and Managed Service Organizations (MSOs), that contract with payors and assume risk on behalf of their network of clinics, also face pressure, exposing providers in their networks to decreased shared savings potential. Many value-based provider organizations that were successful now find it harder to meet performance, forcing many to limit the acceptance of new clinics into their payer contracts.
Independent clinics near a tipping point: lose revenue or find a partner who can help improve quality and efficiency — and bear risk across all payors.
At Better Health Group, we don’t just run a Medicare ACO and a Medicare Advantage MSO, we’re a peer in the clinical community and we know running a successful practice in today’s environment is hard. Reduced reimbursement rates, added documentation requirements, workforce shortages, and supporting multiple value-based contracting partners are forcing clinics to spend less time with more patients.
Clinics using our model practice better medicine, spend 47% more time with their patients, see nearly one-third fewer patients, and achieve top-tier HEDIS and Star Ratings. While clinics using a traditional fee-for-service model or an underperforming value-based care partner would suffer financially, our clinics are running better businesses, with average gains of over $1,000 per patient, per year and a highly engaged clinical team (94%+).
Mike Polen, CEO of Better Health Group, summarizes it best:
“While I’m proud of our ACO results, I’m even more proud of how we’re transforming independent practices. With the recent changes to Medicare, it’s a tough time for all of us who run primary care clinics. Our model provides the support and information providers and their staff need. We give them more time to spend with their patients, leading to higher-quality care, at a lower cost for everyone. And with our ability to take on more risk for a greater reward than most ACOs and MSOs, our network of providers get to keep more of the financial value they create.”
Choose your ACO wisely. Go beyond MSSP and REACH. Know your options.
If you’re selecting an ACO partner, based only on their shared savings or monthly REACH payments, you are most likely not achieving maximum value. Before you enroll in MSSP or Reach for 2026, or sign a longer-term Medicare Advantage contract, ask these 5 questions:
- What were your most recent ACO and MA performance results?
- What tools and staffing will you provide, in and out of my clinic, to help adopt value-based care and improve my coding accuracy?
- How soon will my clinic see revenue increases or shared savings bonuses?
- For my MA contracts, how will the 2025 benefit designs impact my shared savings?
- Can my shared savings be reduced due to other low-performing clinics in your network?
Free Report: See your clinic’s missed revenue opportunities and what your ACO is costing you.