What does ACO mean in healthcare?

What does ACO mean in healthcare?

Accountable Care Organizations
Accountable Care Organizations (ACOs) What is an ACO? ACOs are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high-quality care to their Medicare patients.

What is Pioneer ACO program?

The Pioneer ACO Model is a CMS Innovation Center initiative designed to support organizations with experience operating as Accountable Care Organizations (ACOs) or in similar arrangements in providing more coordinated care to beneficiaries at a lower cost to Medicare.

What could cause an ACO to not meet expenditure benchmarks?

After studying the conceptual and operational issues, it is concluded herein that ACOs are in the long-haul doomed for failure since: 1) most hospitals and physicians have major difficulties in consummating tightly coordinated collaborative efforts; 2) providers historically have had a dismal track record in reducing …

What is ACO position?

What is an ACO? Accountable Care Organizations (ACOs) are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to their Medicare patients.

What is the purpose of joining an ACO?

ACOs are groups of doctors, practices, hospitals and (sometimes) insurance companies that join together to provide higher-quality patient care, improve care coordination and make more cost-efficient health care decisions. The ACO must meet certain benchmarks for keeping patients healthy and out of the hospital.

What is an example of an ACO?

Many ACOs will also include hospitals, home health agencies, nursing homes, and perhaps other delivery organizations. Some examples are Kaiser Permanente, Group Health Cooperative of Puget Sound, and Geisinger Health System.

What type of payment does an ACO receive?

An upfront, variable payment: Each ACO received a payment based on the number of its historically-assigned beneficiaries. A monthly payment of varying amount depending on the size of the ACO: Each ACO received a monthly payment based on the number of its historically-assigned beneficiaries.

What was the first ACO?

Pioneer ACOs The Pioneer ACO was specifically designed to work with those early adopters of coordinated care who had already developed high performing networks. The model assumed higher risk and shared savings than the MSSP.

What are the disadvantages of an ACO?

Cons. Limited choice: With so many healthcare providers joining ACOs, some patients will have trouble finding doctors outside of a specific group. The shortage of options could lead to higher patient costs. Referral restrictions: ACOs provide doctors incentives to refer to specialists within the group.

Are ACO working?

ACOs are improving care quality and starting to reduce costs At the same time, the organizations generated about $314 million in net Medicare savings, with 34 percent earning shared savings payments. The MSSP, the largest ACO program currently in operation, has had overwhelming success with care quality performance.

Why should I join an ACO?

ACOs can provide opportunities for physicians and practices to operate more efficiently and share in health care cost savings, while saving patients time, money and effort on unnecessary visits and medical procedures. If you decide to join an ACO, make sure you carefully weigh the potential risks and rewards first.