What is an Accountable Care Organization?


An accountable care organization (ACO) according to the government is a group of health care providers who give coordinated care, chronic disease management, and thereby improve the quality of care patients get. The organization's payment is tied to achieving health care quality goals and outcomes that result in cost savings.

Accountable care organizations will be largely based on physician practices.

There are models out there already.

Integrated Delivery Systems
A common ownership of entities that may include an insurance plan. Kaiser Permanente is one example.

Multispecialty Group Practices
Group practices that own or have a strong affiliation with a hospital. Mayo Clinic and Cleveland Clinic are two examples. They have a long history of physician leadership and sophisticated delivery systems.

Physician-Hospital Organizations
These organizations are a subset of the hospital’s medical staff. Some function like multispecialty group practices, focusing on reorganizing the delivery of care.

Independent Practice Associations
Independent practice associations consist of individual physician practices that come together to gain clout for contracting purposes. Over time many have evolved into more-organized networks of practices that are actively engaged in quality improvement initiatives.

Virtual Physician Organizations
Rural physician practices organized as “virtual” physician organizations.

Community Care of North Carolina is one example. As their web site states they are building community health networks organized and operated by community physicians, hospitals, health departments, and departments of social services. By establishing regional networks, the program is establishing the local systems that are needed to achieve long-term quality, cost, access and utilization objectives in the management of care.

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