For Providers

What is an ACO?

Accountable Care Organizations (ACOs) are networks of health care providers that agree to be accountable for the quality, cost, and overall care of patients.

ACOs are accountable to patients and contracted third-party payers by providing programs and services addressing the improvement of quality, care coordination, accessibility, and efficiency of care and reducing the total cost of care. ACO providers work together to improve patient experience and outcomes by providing quality, effective, team-based integrated care.

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What does this mean for your patients?
ACOs are designed to help physicians provide high-quality care at the right time, in the right place. In an ACO, patients benefit when their physicians are committed to team-based care and accept their role in reducing health care costs. As a patient you may notice your physician:

  • Created a specific care plan for you
  • Knows about your entire health profile (e.g. your health issues and how they have been treated, what lab tests have been done…etc.) because they are coordinating your care with other physicians and specialists
  • Using telehealth applications and technologies such as eVisits.

ACOs offer specific services and tools to their physician members to help them improve and coordinate the care of their patients; e.g. complex care services for high-risk patients with chronic medical conditions, population health for patient outreach and tracking preventative screenings, analytics for identifying gaps in care, and managed care for facilitating care within the ACOs network of physicians and other health care services.


Background
On March 31, 2011, the US Department of Health and Human Services proposed the initial set of guidelines for the establishment of ACOs under the Medicare Shared Savings Program (Section 3022 of the Patient Protection and Affordable Care Act). These guidelines outline the necessary steps that voluntary groups of physicians, hospitals, and other health care providers must complete in order to participate in ACOs.