WHY ACCOUNTABLE CARE ORGANIZATIONS?

What is an ACO?

Accountable Care Organizations are groups of hospitals, physicians and other healthcare providers who come together to be accountable, both clincally and financially, for the care of certain individuals. ACOs have become synonymous with the value-based movement in healthcare.

ACOs manage Medicare, Medicaid and Commercial populations. Their physicians and practicitioners care for indivuals with all types of insurance and payers or none at all. While the over 1,000 ACOs vary in terms of capabilities, there are certain commonalities. Below are some of the services that most ACOs have in common.

Focus on Quality

ACOs, which report the quality measures on behalf of their providers, are required to meet certain minimum standards to their conditions of participation. Physicians who participate in ACOs on average have higher quality scores than that of physicians who are not in an ACO. Roughly half of physicians in the United States participate in an ACO. We belive ACO particiaption is an indicator of the physician’s commitment to provide the highest standard of care possible.

Care Management Services

A primary mission of ACOs is to coordinate care effectively among providers using an organized program of care management. These value-based support systems help those who suffer from chronic illness and those recovering from an acute episode to better manage their health and lead to improved outcomes.

Member Engagement Programs

ACOs have led the industry with interactive health programs developed to engage members more effectively. Good health requires a collective effort of both patient and practitioner.

Innovative Technologies

ACOs utilize the latest in technology to improve outcomes for the health of the populations they are responsible. Such capabilities allow ACOs to share critical data among members of the care team and their patients, while at the same time safegaurding it against misuse.

Transparency

ACOs who participate in the Medicare Shared Savings Program are required to post their performance data on their website in a format prescribed and data populated by Medicare. Such transparency allows consumers to be fully informed about their healthcare choices.

Fast Facts about the Medicare Shared Savings Program

Above is an informational piece published by Medicare about the Medicare ACO program. While the above information relates only to services delivered to traditional Medicare beneficiaries, it highlights many of the successes of the program. With nearly a half million providers involved, the Shared Savings Program includes many of the top perforing healthcare providers in the country. Most also offer services to a large variety of payers, and many contract directly with employer health plans.