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Accountable Care Organizations

ACO

Understanding and Implementing an ACO

An Accountable Care Organization (ACO) is a formally organized entity, consisting of physicians, hospitals and other relevant health service professionals that have elected to join together and are responsible through contracts with payers for providing a broad set of health care services to their Medicare patients.

This entity is accountable for organizing and aligning health care services to deliver seamless, coordinated care whether the ACO is contained within a single corporate structure or is an organized network of independent but associated health care professionals.

The impetus is to change the way providers are paid. Instead of getting paid for each service ACOs reward providers that are able to manage chronic disease and meet certain quality measures, including reducing hospital admissions and emergency room visits. If the quality of care improves and costs are constrained, the systems can share in the savings.

Understanding Accountable Care Organizations:

Medicare ACO Programs

Medicare offers several ACO programs, including:

  • Shared Savings Program
    A Shared Savings Program facilitates coordination and cooperation among providers to improve the quality of care for Medicare Fee-For-Service (FFS) beneficiaries and reduce unnecessary costs. Learn More
  • Advanced Payment Model
    The Advance Payment Model is designed for physician-based and rural providers who have come together voluntarily to give coordinated high quality care to the Medicare patients they serve. Learn More

ACP Comments to the CMS Centers for Medicare and Medicaid Innovation's Advanced Payment Initiative

  • Pioneer Model
    A more advanced ACO, the Pioneer ACO Model is designed for health care organizations and providers that are already experienced in coordinating care for patients across care settings. Learn More

ACP Summary of New ACO Initiatives through the CMS Innovation Center - Pioneer ACO Model, Advanced Payment Initiative, and the Accelerated Development Learning Sessions (announced May 2011)

Additional Resources

Additional ACO Information and Resources

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