Accountable Care Organization .

• Accountable Care Organization

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Accountable care organization

1 An 'accountable care organization' (ACO) is a healthcare organization

characterized by a payment and care delivery model that seeks to tie

provider reimbursements to quality metrics and reductions in the total

cost of care for an assigned population of patients


Accountable care organization - History

1 Accountable Care Organizations, Explained


Accountable care organization - History

1 Medicare announced 32 ACOs in December 2011,[http://innovation.cms.gov/initiatives/Pioneer-ACO-

Model/ Pioneer ACO Model] 27 in April 2012,[http://www.cms.gov/apps/media/press/factsheet.asp

?Counter=4334 FIRST ACCOUNTABLE CARE ORGANIZATIONS] nearly 90 in July

2012,[http://www.cms.gov/apps/media/press/factsheet.asp?Counter=4405 CMS NAMES 88 NEW] and over a hundred in January 2013.[http://www.cms.gov/Medicare/Medicare-

Fee-for-Service-Payment/sharedsavingsprogram/News.html Program News and Announcements] The complete list of

ACOs[http://globe1234.homestead.com/aco.xls Accountable Care Organizations] has providers in most

states.


Accountable care organization - Cost savings

1 Medicare Shared Savings Program:Accountable Care Organizations;

Proposed Rules


Accountable care organization - In the Affordable Care Act

1 http://www.acofp.org/Practice_Management/ACO/Medical_Home/ According to the ACA,

the MSSP promotes accountability for a patient population and coordinates items and services under part A and B, and encourages investment in infrastructure and redesigned care processes for high quality and efficient service delivery.Medicare Accountable Care

Organizations Shared Savings Program - New Section 1899 of Title XVIII, Preliminary

Questions Answers



1 Medicare Shared Savings Program: Accountable Care Organizations; Proposed

Rules



1 After the initial set of regulations released in March, 2011, CMS received feedback regarding streamlining the

governance and reporting burdens and improving the potential financial return for ACOs willing to make the necessary, and often substantial, investments to

improve care.Health Policy Brief: Accountable Care Organizations, Health

Affairs, July 27, 2010



1 http://www.kaiserhealthnews.org/stories/2011/october/20/accountable-

care-organization-rules-regulations.aspxProposed Rule

versus Final Rule for Accountable Care Organizations in the Medicare

Shared Savings Program


Accountable care organization - ACO Payment Models

1 Medicare Program: Medicare Shared Savings Program: Accountable Care Organizations


Accountable care organization - ACO Quality Measures

1 To address the goal of improving healthcare quality, CMS has established five domains in

which to evaluate the quality of an ACO’s performance. The five domains are

patient/caregiver experience, care coordination, patient safety, preventative health, and at-risk population/frail elderly health. Department of

Health and Human Services: Centers for Medicare and Medicaid (2011). Medicare

Program: Medicare Shared Savings Program: Accountable Care Organizations. Federal

Register. p.19570


Accountable care organization - Providers

1 Accountable Care Organizations: A new model for

sustainable innovation


Accountable care organization - Patients

1 An ACO’s patient population will primarily consist of Medicare beneficiaries. In larger

and more integrated ACOs, the patient population may also include those who are homeless and uninsured. Patients may play a role in the healthcare they receive from their ACOs by participating in their ACO’s

decision-making processes.Springgate, B.F., Brook, R.H. (2011). Accountable Care

Organizations and Community Empowerment. Health Affairs. p.1800-1801


Accountable care organization - ACO Pilots and Learning Networks

1 Health Policy Brief: Accountable Care

Organizations


Accountable care organization - Challenges

1 Department of justice/federal trade commission issue final statement of

antitrust policy enforcement regarding accountable care

organizations


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