Accountable Care Organizations

An accountable care organization (ACO) is an organization of health care providers that agrees to be accountable for the quality, cost and overall care of Medicare benefiaries. It is a type of health plan or system concept that was included as an innovation opportunity within the Patient Protection and Affordable Care Act (PPACA). 

An organization must meet several requirements in order to become an ACO. The Centers for Medicare and Medicaid Services (CMS) drafted proposed regulations related to the credentialing of an ACO, which includes requirements like a minimum 5,000 patient centered panel, linkages to specialties and the goal of improving coordination of care.

Various health plans are proposing alternatives to ACOs, such as bundled payments and partial capitation.

Resources

New Affordable Care Act tools offer incentives for providers to work together when caring for people with Medicare (healthcare.gov)

ACOs and PCMHs: Update, legal requirements and practical considerations before pursuing (presentation by Jim Daniel, Jr., J.D., MBA)

CMS announces ACO proposed rules (HDJN client advisory)

Comparison of payment reform models (healthreformwatch.com)

Medicare shared savings program (cms.gov)

ACOs, co-ops and other options: A "how-to" manual for physicians navigating a post-health reform world (ama-assn.org)

Lessons from the field: Making Accountable Care Organizations real (nihcr.org)