APCM Implementation Checklist for ACOs | MSSP Savings

Review CMS beneficiary assignment lists to identify patients eligible for APCM, ensuring alignment with your ACO's current risk-based contracts.

Calculate the impact of APCM on total cost of care by projecting reductions in avoidable ER visits and inpatient admissions through better monitoring.

Evaluate how APCM G-code revenue interacts with existing FQHC, RHC, or standard fee-for-service billing within your network TINs.

Establish standardized procedures for participating practices to submit APCM claims to ensure consistent revenue capture across the ACO.

Set specific performance indicators for AI-driven patient outreach to measure cost-per-enrolled-beneficiary versus manual staffing costs.

Utilize AI-powered voice agents to provide 24/7 access to care, meeting CMS requirements while reducing the burden on individual practice staff.

Create uniform electronic care plan templates that satisfy both APCM requirements and ACO-specific quality reporting needs.

Use AI voice automation to contact high-risk beneficiaries and explain the benefits of APCM, securing the necessary verbal or written consent.

Ensure that AI-captured data and care notes flow seamlessly into the EHRs of all participating TINs to maintain a single source of truth.

Conduct training sessions to ensure practice managers understand how APCM participation contributes to the ACO's overall shared savings.

Map APCM documentation requirements to specific ACO quality measures like HbA1c control and blood pressure management to streamline reporting.

Program the AI call center to identify and address outstanding care gaps during routine monthly APCM check-in calls.

Verify that all AI interactions and data storage protocols meet HIPAA standards for PHI protection across the entire ACO network.

Maintain a digital audit trail of beneficiary consent for APCM services to satisfy CMS documentation and audit requirements.

Create a centralized repository of call logs and care management minutes to simplify the response to CMS or MSSP program audits.

Scale your outreach by using AI to conduct routine monthly check-ins, ensuring every eligible beneficiary receives the required care management time.

Utilize AI voice agents to prompt patients for medication updates, flagging potential discrepancies for review by an ACO pharmacist.

Integrate Social Determinants of Health screening into AI workflows to identify barriers to care like transportation or food insecurity.

Configure the AI system to instantly route patients reporting acute symptoms to the appropriate clinical staff within the ACO.

Automatically collect Net Promoter Scores (NPS) following AI interactions to monitor the impact of APCM on the patient experience.