Acadia has created the first of its kind consultancy group designed specifically to assist physicians participate and succeed in value-based care. Acadia is simultaneously building out an advisory board with some of the greatest thinkers in healthcare risk. (Click here to see our initial members.)

As part of Acadia’s multi-faceted approach to supporting its healthcare clients throughout the US, we are developing a “stop loss” market for physicians taking downside risk in value-based care programs.

Physicians can count on Acadia to provide the most comprehensive education and resources related to VBC programs, which include:


Accountable Care Organizations (ACOs) have given many independent physicians the ability to share in the healthcare cost savings that they can help generate. The compositions of ACO’s vary greatly, but most physician-owned and run ACO’s have not yet been taking substantial downside risk.

As ACOs progress through their “tracks,” more and more risk will need to be taken to remain in the program. Moreover, by agreeing to assume greater downside risk, ACOs are eligible for greater potential upside gains.

Acadia has the markets and the resources to assist ACOs manage their downside risk while maximizing savings.


Bundled Payment for Care Improvement – Advanced (BPCI-A) was one of the first CMS programs that gave physicians priority over hospitals (although many “episodes” are only triggered via a hospital visit). BPCI-A is a program that allows providers and/ or their convener partners to realize savings associated with reducing the cost of certain episodes of care.

Though a large potential upside, BPCI-A participants are required to take downside risk, subject to certain caps. Acadia works with conveners and providers alike to manage, reduce and transfer BPCI-A downside risk.

Many conveners are unaware that options for BPCI-A stop loss exist. Contact Acadia to learn how we can save you money on stop loss.

Direct Contracting Entities

While the new CMS direct contracting entities model offers considerable opportunities to participants, it also requires them to take on significant downside risk.

CMS has set a variety of caps and risk corridors to protect extreme losses. It is also offering its own stop-loss coverage, at a premium to be announced.

All participants should conduct their due diligence and obtain pricing from both the government and private market. Acadia works with the most sophisticated stop loss underwriting teams in the US. We can help


This model offers four different tracks, each with a different amount of risk, and thus, a different amount of potential reward:
  1. Kidney Care First (KCF) Option: This is a no risk option, with adjusted payments for managing beneficiaries with CKD stages 4 & 5 and ESRD.  KCF includes a kidney transplant potential bonus payment.
  2. Comprehensive Kidney Care Contracting (CKCC) Graduated Option: A one-sided (no risk) track, which allows participants to gain insights and comfort into the program, and later graduate into a larger risk track.
  3. Comprehensive Kidney Care Contracting (CKCC) Professional Option – Up to 50% shared savings, though responsible for 50% of shared losses based on the total cost of care for Part A and B services.
  4. Comprehensive Kidney Care Contracting (CKCC) Global Option – 100% risk of the total cost of care for all Parts A and B services for aligned beneficiaries.


For the Oncology Care Model (OCM), Acadia partnered with IronShore to offer an exclusive stop loss program to cover two-sided risk.

Acadia is working with the most respected names in oncology throughout the US to help them manage their downside risk. OCM has highly complex rules that require a thorough understanding to be successful. Acadia works with the leading firms throughout the nation to help ensure participant success.

Call us to learn more about how we can help you, and why we are the recognized leaders in oncology risk.


Likely to be the successor program to OCM, Oncology Care First (OCF) details are being closely monitored by Acadia’s nationally renowned VBC consulting group.

OCF is believed to require downside risk from the start. Groups should begin preparing now for OCF and positioning themselves for success. Contact us to learn more.

Private Payors

Private payors have been slow to adopt VBC. Some are more focused on buying up and controlling their own physician networks; few have understood the incentives to make meaningful investments in VBC.

A select few innovative teams have nonetheless been hard at work running value-based pilot programs for physician groups across the nation. Participants range from primary care groups looking to control costs for populations, to specialists that have developed innovative ideas around certain diagnoses or procedures.

To get access to these teams, groups must first build their data infrastructure and understand the nuances of VBC and risk. Acadia helps groups do just that.

Direct to Employers

Considered the “holy grail” of value-based care, exceptional practices throughout the country have their eye on providing all care – whether primary or specialty – for employees of specific corporations.

These efforts are well under way, as groups prepare to make the case that they can reduce the cost of healthcare for employees.

There are many steps that forward-thinking, independent physicians can take to position themselves for success under a DTE model. Waiting is not one of them.

Medical Homes

Some states have rolled out “medical home” models designed to manage specific diagnoses. While downside risk and penalties have not been a major aspect of medical homes initially, more are moving to a two-sided risk structure.

Before signing on to a program with risk, contact Acadia for help navigating it.

Our Carriers

Healthcare Trusts Acadia.

Superior Coverage. Great Prices.
Healthcare is in a time of great transition, demanding customized programs to address emerging risks. Our team of professionals will work with you to find best in class solutions to address enterprise-wide professional liability exposure. 

Superior Carriers Relationships
Our national network of highly rated carriers is second to none. We work for you and not the insurance companies, providing us with the ability to independently analyze and recommend the most appropriate carrier now and in the future.

Experience and Expertise.
We have a combined experience of 50 years helping physicians, executives and healthcare institutions of all sizes secure medical malpractice insurance. Our team is built on experience and expertise.


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