Florence works for primary care

Payment Structures

How Florence pays PCPs more for their care

Your existing Medicare FFS revenue stays untouched. Florence layers structured in-year payments on top — and every option includes practice-isolated shared savings at year-end.

Option A

Fee Schedule Increase

% FFS increase
+ 100% FFS base

Scales with performance

A percentage increase above standard Medicare FFS applied to eligible E&M services. Cleanest option if you think in terms of Medicare fee schedule.

Option B

Per-Visit Fixed Bonus

$ per E&M visit
+ 100% FFS base

Scales with performance

A flat dollar amount per eligible E&M visit, additive to FFS. Best option for practices that want a fixed visit incentive regardless of E&M CPT code.

Option C

Per Member Per Month

$ PMPM
+ 100% FFS base

Scales with performance

A fixed monthly add-on payment per attributed patient. Preferred choice for providers who want to unlink financial incentives from visit volume altogether.

Advance rates are tied to MLR performance bands. Better cost stewardship unlocks higher rates. You select your mechanism before the year starts.

All options include a year-end shared savings distribution based on your individual performance. In-year advances are the floor, not the ceiling.

Payment structures shown are illustrative. Actual terms established in each practice's participation agreement.

What Practices Face Today

Most independent practices are already in an ACO — but many still deal with pooled performance, payments delayed 9–22 months, and limited visibility into what they're actually earning. If your results don't reflect your care, the problem isn't your medicine. It's your ACO's structure.

The Model

Four pillars that set Florence apart

Practice-Isolated Performance

Your performance is measured and rewarded at your practice level — not pooled across a larger network. In a traditional pooled model, high performers subsidize lower performers. At Florence, clinical excellence directly translates into higher savings.

No pooling · No dilution

Flexible Monthly Cash Flow

Traditional ACO participation means waiting 9–22 months after care delivery to receive shared savings. Florence offers structured in-year advances plus a year-end shared savings distribution — all tied to your individual performance.

In-year advances from day one

Maximum Shared Savings

Florence participates in the Enhanced MSSP track to maximize shared savings potential. Practices don't earn more by keeping a bigger slice — they earn more by participating in a higher-performing ACO with a larger total pool.

Enhanced MSSP track

The Florence Success Model

Ongoing, hands-on support focused on execution, improvement, and results — not just reporting. Monthly performance reviews, care gap identification, and provider-level NPI reporting tied directly to your savings outcome.

Active partnership
Pooled vs Isolated

Why structure determines results

Two practices can be in the same MSSP track and experience very different results. The difference is how performance is measured and rewarded.

Network Pooled Model (Other ACOs)

  • High performers contribute more but receive less back than they generated
  • High performers carry underperformers
  • Upside capped by network averages
  • Reduced incentive for excellence
  • Less transparency in distributions

Florence Practice-isolated Model

  • No shared pool — you keep what you earn
  • No dilution of performance
  • No subsidizing underperformers
  • Direct link between care quality and revenue
  • Maximum upside for strong operators
The Florence Success Model

Three focus areas that drive results

Structured, active partnership — not passive dashboards.

Patient Access & Care Coordination

Preventive care that actually happens.

  • Facilitates AWVs, TCMs, and high-impact visits
  • Risk-stratified patient outreach
  • Cross-source data analysis for actionable insights
  • Patient attribution and assignment protection

Data-Driven Clinical Insights

Powered by our proprietary Nightingale platform.

  • Works alongside your EHR without disruption
  • Holistic view across claims, EHR, care gaps, and risk
  • Real-time spend visibility by category
  • Predictive risk assessment

Financial Visibility & Partnership

Clear financials, no surprises, continuous support.

  • Practice- and provider-level financials by NPI
  • Always-on dashboard with refreshed data
  • Monthly partnership meetings with projections
  • Actionable recommendations tied to outcomes
Getting Started

Implementation takes weeks, not months

Onboarding typically takes 2–4 weeks with approximately 4–6 total hours of your practice's time.

Phase 1

Initial Alignment

A 45–60 minute session with Florence, your providers, and staff to align on goals and review workflows.

Phase 2

Data & Technology Setup

Patient roster setup, EMR access, Nightingale onboarding with guided platform training.

Phase 3

Operational Readiness

Pre-launch touchpoints to confirm expectations, complete setup, and ensure payment routing.

Phase 4

Program Year Start

Patient assignment from CMS, payment start, regular 1-on-1 PCP touchpoints, ongoing operating cadence begins.

Ready to see how it works for your practice?

No pressure, no obligation — just a straightforward conversation about what Florence could look like for you.

Request an Offer Schedule a 15-Minute Call