Thursday, March 21, 2013

Are Accountable Care Organizations (ACOs) only for Medicare beneficiaries?



At the present time, Medicare funds are supporting ACO formation around the country to serve Medicare beneficiaries.  In January 2013, CMS announced 106 new organizations will be participating in the Medicare-sponsored ACO programs, taking the participation numbers to over 250 nationwide.

Additionally, some states are looking at the ACO to service Medicaid patients in their attempt to improve quality and reduce costs.

Some commercial insurers are supporting ACO development for their own members as well.
Innovative physician-led organized groups have been following the ACO care model with all of their patients for decades and are participating in both Medicare and commercial ACO pilot programs.  

The intention of the Affordable Care Act is that ACOs will eventually be available to everyone.  Multispecialty medical groups, physician-hospital organizations (PHOs), integrated delivery systems (IDSs), and independent practice associations (IPAs) are likely candidates to become the ACOs of the future.

ACO Programs at CMS

Medicare offers several ACO programs, including:
General information on ACOs can also be found at cms.gov/aco and this HealthCare.gov ACO Fact Sheet.

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