What is an ACO?
Simply stated, an accountable care organization (ACO) is a group of health care providers who agree to share responsibility for the quality, cost, and coordination of care for a defined population of patients.
- An ACO can be nearly any combination of group practices, networks of practices, hospitals, hospitals employing other providers, hospital-physician joint ventures, etc., as long as it is legally capable of receiving and distributing payments.
- An ACO works with one or more payers (most commonly Medicare) to achieve the triple aim of improving population health, improving patients’ experiences of care, and reducing the total cost of care.
- If an ACO saves money for the payer without compromising quality, it shares in the savings. Some contracts specify that if an ACO costs the payer more, it shares in the loss.
- A successful ACO is composed of empowered primary care physicians who have the resources, data, and leadership to coordinate and manage care for patients across the entire community. Family physicians and other primary care providers are the most important element in any ACO.
The ACO health care model is part of the 2009 Patient Protection and Affordable Care Act (PPACA), and payers hope that ACOs will save money while improving quality. Consequently, ACOs are likely to be an important part of the future for all family physicians. More than 400 ACOs have been started or announced to date, and still more are on the way.
Other ACO Resources:
This guide explores the trends driving physicians toward collaboration and affiliation, weighs the advantages and disadvantages of various affiliation options, and provides a detailed analysis of the hospital employment model. It looks at legal implications of various practice affiliations, and how the patient-centered medical home can be incorporated into these models.
Is a two-part guide to help family physicians develop their strategy to evaluate and implement a successful accountable care organization. Part one examines these new organizations and identifies essential elements, generally addressing specialties and facilities. Part two applies the principles and processes of the guide specifically for the family physician.