Accountable Care Organizations

(ACO)

ASSIGNMENT 3.2
MICHELE M. HORNICK
MEDAILLE COLLEGE

AUTHOR NOTE
THIS PAPER WAS PREPARED ON 9/27/2016 FOR
MANAGEMENT AND ORGANIZATION FOR HEALTH
PROFESSIONALS - HIA 440E, TAUGHT BY TERESA
REINHARDT.
Table of Contents

Introduction
What is an ACO?
Requirements to become an ACO
The Goal of an ACO
ACO Models
Participating Providers
Services Provided
ACO vs. HMO
Conclusion
Introduction

Healthcare in the United States is constantly

evolving to improve upon itself. Vaccines eliminated
the threat of specific diseases that formerly plagued
the population. The electronic health record (EHR)
has revolutionized the way in which providers access
patient information. ACOs may very well
revolutionize patient care delivery.
What is an ACO?

An Accountable Care Organization is a collaboration

of physicians, hospitals, and other healthcare
providers that voluntarily agree to be clinically and
financially responsible for the healthcare delivery in
their community. An ACO provides team-based
coordinated care to their patients.
The Goal of an ACO

The goal of an ACO is to improve upon the quality

and efficiency of the care that is provided to patients
in the most cost effective manner.
ACO Models

There are 5 ACO models:

Integrated Delivery Systems common ownership of hospitals, physician practices

and perhaps insurance companies with well aligned financial incentives, electronic
medical records, team-based care and resources to support cost-effective care
Multispecialty Group Practice have strong affiliations with hospitals. They
usually dont own the health plan, but have contracts with multiple health plans
Physician-Hospital Organizations subset of the hospitals medical staff some
function like multispecialty group practices
Independent Practice Associations individual physician practices that come
together to contract with health plans
Virtual Physician Organizations generally physicians in rural areas

(5 Types of Accountable Care Organizations (ACOs), 2013)

Participating Providers

The fundamental purpose of an ACO is to develop

and provide a multi-disciplinary team.

The ACO model will determine the providers that

participate within a specific ACO.
Services Provided

Beyond the care that a patient is used to receiving,

an ACO will also provide:
Patient centered care
Population Health Management
Utilization management
Referral management
ACO vs. HMO

Like apples and oranges are similar, so are ACOs and

HMOs.
Both focus on the coordination of care, but that is where
their similarities end.
HMO- The insurance company oversees the treatment of
their members. They dictate the providers that are fully
covered and the services that are allowable.
ACO- The primary care provider oversees the care of
his/her patients.
Conclusion

ACOs are revolutionizing the way healthcare is

delivered in the United States. Providers are
voluntarily agreeing to collaborate with one another
to ensure that care is provided in a manner that
improves the cost, quality, and efficiency.
References

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Healthcare Solutions: http://bhmpc.com/2013/02/5-types-of-accountable-care-organizations-
acos/
Accountable Care Organizations (ACO) . (2015, January 6). Retrieved from Centers for
Medicare and Medicaid Services: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-
Payment/ACO/index.html
Accountable Care Organizations. (2016). Retrieved from The Official U.S. Government Site for
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