According to HHS Secretary Kathleen Sebelius, 106 new Accountable Care Organizations (ACOs) have been formed by doctors and health care providers. ACO’s are groups of doctors, hospitals, and other health care providers who voluntarily provide coordinated care to Medicare patients, which helps to ensure patients get the right care at the proper time and avoid duplication of services and medical errors. This process ensures high quality health care and lower expenditures for CMS and beneficiaries. The 106 new ACOs will give as many as 4 million Medicare beneficiaries access to high quality coordinated care.
The establishment of ACOs began after the passage of the Affordable Care Act (ACA) (P.L. 111-148), with more than 250 ACOs at this time. ACOs are required to meet quality standards to ensure that savings are being achieved through improved care coordination and appropriate, safe and timely medical care. There are 33 quality measures that ACOs must meet. Estimates show that over four years, ACOs could save the federal government $940 million.
According to CMS, the new ACOs cover a diverse group of physician practices all over the United States. Currently, half of all ACOs are physician-led organizations that serve less than 10,000 Medicare beneficiaries. Twenty percent of ACOs include community health centers, rural health centers and critical access hospitals that serve low-income or rural communities. Fifteen of the new ACOs are Advance Payment Model ACOs, which are designed for physician-based and rural providers. Selected participants in Advance Payment Models receive upfront and monthly payments that they can use to make investments in their care coordination infrastructure. According to CMS, the Advanced Payment Model will help entities with less access to capital participate in the program. Originally available only to entities who began participating on April 1, 2012, or July 1, 2012, in June of 2012 CMS announced it would begin accepting applications for participation for programs beginning on January 1, 2013.