Accountable Care Org’s Approved for Medicare

Under the Affordable Care Act, Medicare’s Shared Savings Program offers financial incentives for physicians, hospitals and other health care providers to join together to form accountable care organizations (ACOs). ACOs are designed to improve care for Medicare beneficiaries and contain increasing costs by changing payment incentives for doctors and hospitals.

Instead of getting paid for each service, ACOs reward providers that are able to manage chronic disease and meet certain quality measures, including reducing hospital admissions and emergency room visits. If the ACO improves care while containing costs, the partners in the ACO can share in the savings. Kaiser Health News has published a useful  “Frequently Asked Questions” guide to ACOs that can be accessed here.

Yesterday, the Centers for Medicare and Medicaid Services announced that 27 health systems have been approved as ACOs. The new ACOs will serve an estimated 375,000 beneficiaries in 18 states.  In New York, the groups are the Accountable Care Coalition of Mount Kisco; the Accountable Care Coalition of the North Country; the Chinese Community ACO; the CIPA Western New York IPA; and the Crystal Run Healthcare ACO.

The approval of the new ACOs brings the total number of approved ACOs organizations participating in Medicare shared savings initiatives on April 1st to 65. This includes the 32 Pioneer Model ACOs that were announced in December, and the six Physician Group Practice Transition Demonstration organizations that started in January 2011.  In all, as of April 1st, more than 1.1 million beneficiaries are receiving care from providers participating in Medicare shared savings initiatives.  CMS is reviewing another 150 applications from additional ACOs seeking to enter the program in July.

-Jaime Venditti, 4/12/12