Our Approach
Your organization has committed to providing high-quality, coordinated health care through participation in a Commercial, Medicare Shared Savings Program, or REACH ACO. At Wilems Resource Group, our main goal is to offer ACO compliance support to alleviate the burdens and challenges your organization may face related to compliance requirements and engagement programs. We understand that your team needs to focus on the most important aspect of health care...the beneficiary.
Wilems Resource Group measures success by our ability to help you understand program and model requirements, determine the appropriate level of acceptable compliance risk, and create Medicare compliance programs that meet all regulatory requirements. We have assisted organizations across the country in remaining compliant and thriving within Medicare value-based care models and programs. By taking the time to understand your company culture and business goals, we listen and learn from you. Working alongside your team, we then build customized healthcare consulting services, including compliance and engagement programs for your organization, physicians, practice managers, and beneficiaries.
Featured Clients
Our Comprehensive Description of Services (pdf)
DownloadOur Services
ACO Compliance Program Consulting
ACO COMPLIANCE OFFICER
Kimberly Busenbark will serve as the named Compliance Officer, and the WRG team provides essential ACO compliance support for day-to-day compliance operations. The activities of the Compliance Team can be difficult to foresee; it may include, but is not limited to:
Documentation & Audit Preparedness for CMS Audits
Investigation, Management, & Documentation of Compliance Issues and Privacy Concerns
Marketing Material Submission and Reviews
Website & Public Disclosure Oversight
CMS Liaison Responsibilities
Effective & Compliant Implementation of Operational Requirements, including Training, Monitoring, Benefit Enhancements, and Waivers
COMPLIANCE PROGRAM MANAGEMENT
We'll support the named ACO Compliance Officer with day-to-day operations and activities, enhancing your compliance program with our healthcare consulting services.
COMPLIANCE PROGRAM AND POLICY & PROCEDURE CREATION
We'll utilize existing elements to build a program and documentation that reflects the operational activities currently in place at the ACO, ensuring alignment with Medicare compliance programs.
ACO COMPLIANCE EDUCATION FOR LEADERSHIP
We'll develop and deliver a customized training to educate your ACO leadership on compliance program requirements, operational considerations, audit preparedness, best practices, and CMS red flag issues.
GENERAL COMPLIANCE RESOURCE
We'll be available if and when you need us to support the ACO Compliance Team.
ACO Compliance Program Audits & Reviews
COMPLIANCE PROGRAM READINESS REVIEW
Our healthcare consulting services include a thorough review of documentation to determine if the ACO operations meet the minimum regulatory requirements. We provide ACO compliance support to help close any identified gaps through either a hands-off approach (Corrective Action Review) or a hands-on approach (Corrective Action Implementation).
RESPOND TO CMS AUDITS
As part of our ACO compliance support, we'll assist the ACO in creating and finalizing a comprehensive response to a CMS audit.
MOCK AUDITS
We offer mock audits that simulate a CMS audit of the essential program elements. Examples of our mock audits include Compliance Program, Voluntary Alignment, Beneficiary Notification, Roster Management, Written Arrangements, and Benefit Enhancements, all designed to strengthen your Medicare compliance programs.
ACO Engagement & Compliance Operations Consulting
COMPLIANCE PROCESS OVERSIGHT
We'll provide ACO compliance support by helping the ACO implement and operationalize compliance effectively.
PLAN REVIEW & GUIDANCE
Our healthcare consulting services include a thorough review and recommendations based on our expertise with CMS/CMMI guidelines and regulations. We can assist the ACO with:
- Marketing Plans & Materials
- Health Equity Plans
- Medicare compliance programs, including Benefit Enhancement & Beneficiary Engagement Incentive Implementation Plans
BENEFICIARY & PROVIDER ENGAGEMENT
We'll assist the ACO in developing beneficiary and provider engagement initiatives.
Our Products
ACO Compliance Training & Reporting
The Wilems Resource Group web-based platform provides ACO compliance support, allowing individuals to complete compliance training or submit a compliance report anytime and from anywhere. Modules can be purchased separately to meet your organization's specific needs. After completing a training module, individuals submit a brief attestation to confirm their understanding of the material. Monthly completion reports are generated and shared with ACO leadership as part of our healthcare consulting services.
REACH ACO Compliance Training Modules:
ACO Comprehensive Training (includes Overview, FWA, and Privacy in one module)
ACO Consumer Advocate Training
Shared Savings Program ACO Compliance Training Modules:
ACO Comprehensive Training (includes Overview, FWA, and Privacy in one module)
ACO Data Custodian Training
Anonymous Compliance Reporting Tool – This tool enables individuals to report any compliance concerns regarding the organization or activities. Users can choose to report anonymously or provide contact information. Reports are then forwarded to the appropriate leaders within the ACO, ensuring accountability in our Medicare compliance programs.
Contact Us
Reach out to us for ACO compliance support; we’d love to assist you with our healthcare consulting services and Medicare compliance programs.
Client Testimonials
Hear from our happy clients who have benefited from our ACO compliance support and healthcare consulting services, as well as our Medicare compliance programs.
ACO Compliance Consulting Services
Free resources and guidance on ACO Compliance and Engagement
Wilems Resource Group
Serving ACOs Since 2014
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