For Providers

What is an ACO?

An Accountable Care Organization, or ACO, is a group of health care providers – including Primary Care Physicians, specialists, and hospitals – that accept collective accountability for the cost and quality of care delivered to the patients they serve. They work together, coordinating to provide quality, integrated care.s.

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What does this mean for patients?
ACOs are designed to help physicians provide high-quality care at the right 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.

You may also notice:

  • You fill out less forms; because your physicians share information and coordinate your care, they’re all the same page and know your care plan.
  • Less tests and in-person patient-doctor visits. Right care, at the right time, in the right place means a doctor office visit may not be necessary.
  • Access to more care settings; hospitals, clinics, outpatient services, and community resources.

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.