What is an Accountable Care Organization?
An Accountable Care Organization (ACO) is a group of healthcare providers who participate together to share the responsibility for the clinical and financial outcomes experienced by their Medicare Fee-for-Service patients. Under traditional Medicare Fee-for-Service, providers get paid for treatments that they provide, and are not responsible for the care that is provided by others, nor for the value that results from the dollars that are spent on treatment. The ACO model is intended to change that, by making the group as a whole responsible for the health of the Medicare Fee-for-Service patient and rewarding the group for the outcomes that their patient's experience.
The goal of coordinated care is to ensure that patients, especially the chronically ill, get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors.
When an ACO succeeds in delivering both high-quality care and spending health care dollars more wisely, it will share in any resulting savings that is achieved.
The Medicare Shared Savings Program was created as a part of the Affordable Care Act in the health care reform law of 2010, to better coordinate care for Medicare Fee-for-Service patients though ACOs. Instead of patients having to navigate the complex healthcare system on their own, these ACOs will work hand in hand with patients to ensure patients are cared for. ACOs will encourage providers to work more closely together than ever before and offer incentives to providers that better coordinate a patient’s care and treat patients across care settings.
For general questions or additional information about Accountable Care Organizations, please visit www.medicare.gov/acos.html or call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.