What is the ACO model in healthcare?

What is the ACO model in healthcare?

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.

How many ACOs are in the US?

As of January 2021, there are 512 Medicare ACOs serving over 12 million beneficiaries. Since 2010, more than 1,200 organizations have held an ACO contract in Medicare, Medicaid or the commercial sector and serving millions of additional patients.

How does ACO impacts health care providers?

As a result, patients in ACOs may experience increased focus on preventive care early and often. Additionally, by holding providers accountable for the safety, quality and appropriateness of the care they provide, ACOs are designed to help patients avoid unnecessary or duplicative tests and procedures.

Which is better MCO or ACO?

ACO reward health care providers for the quality of care provided to patients, while eliminating irrelevant spending. ACOs do not focus on profit, but the quality of care while MCOs focus on profit.

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.

How many ACOs Are There 2020?

517 ACOs
The Medicare Shared Savings Program (MSSP) — the main Medicare ACO program — has 517 ACOs operating in 2020, which is one fewer than last year, according to Medicare data.

What is ACO risk contracting?

ACOs are networks of hospitals, physicians, specialists, and other combinations of providers that voluntarily contract with a payer to share the medical and financial responsibility for coordinating the care of an assigned population.

What is the difference between PPO and ACO?

There are a number of important similarities and differences between ACOs, HMOs (Health Maintenance Organizations), and PPOs (Preferred Clinician Organizations): An ACO is generally based on a self-defined network of clinicians, whereas in most HMOs and PPOs, the network is defined by a health plan.

What are the benefits of an ACO?


  • Improved population health. One fundamental goal of ACOs is that they will improve the health and wellness of a defined population for which the ACO is accountable.
  • Improved patient quality of care.
  • A focus on the patient.
  • Physician leadership.
  • Lower costs.
  • Shared savings.

How are ACOs paid?

Accountable care organizations (ACOs) are groups of health care providers that have agreed to be held accountable for the cost and quality of care for a group of beneficiaries. Providers both inside and outside the ACO generally continue to be paid their normal fee- for-service (FFS) rates by Medicare.

Is ACO a form of managed care?

Accountable Care Partnership plan In this type of ACO plan, a group of PCPs work with one Managed Care Organization (MCO). They form a network of PCPs, specialists, behavioral health providers, and hospitals. PCPs plan and coordinate care to meet your health care needs.