Under the healthcare reform law, an Accountable Care Organizations (ACO) is a group of providers and suppliers of services (e.g., hospitals, physicians, and others involved in patient care) that will work together to coordinate care for the patients they serve with Medicare. The goal of an ACO is to deliver seamless, high quality care for Medicare beneficiaries.  The ACO is like a patient-centered medical home where the patient and providers are true partners in care decisions.

The Affordable Care Act specifies that an these may include the following types of groups of providers and suppliers of Medicare-covered services:

  • Networks of individual practices of ACO professionals,
  • Partnerships or joint ventures arrangements between hospitals and ACO professionals, or
  • Hospitals employing ACO professionals, and
  • Other Medicare providers and suppliers as determined by the Secretary.

The law requires each entity to include health care providers, suppliers, and Medicare beneficiaries on its governing board. The ACO must take responsibility for at least 5,000 beneficiaries for a period of three years, also suggested in the law.

The law links the amount of shared savings an ACO may receive to its performance on quality standards.  The rule proposes quality measures in five key areas that affect patient care: patient/caregiver experience of care; care coordination; patient safety; preventive health; and at-risk population/frail elderly health.

The ACA sets out proposed performance standards for these measures and a proposed scoring methodology, including proposals to prevent providers in ACOs from being penalized for treating patients with more complex conditions.

Furthermore, any patient who has multiple doctors probably understands the frustration of fragmented and disconnected care:, duplicated medical procedures, lost or unavailable medical charts or having to share the same information over and over with different doctors.  Accountable Care Organizations , like patient-centered medical homes, are designed to lift this burden from patients, while improving the partnership between patients and doctors.  Doctors can provide better care because they will have better information about their patients’ medical history and can communicate with a patient’s other doctors.  Medicare beneficiaries whose doctors participate in an ACO will still have a full choice of providers and can still choose to see doctors outside of the ACO. Patients choosing to receive care from providers participating in ACOs will have access to information about how well their doctors, hospitals, or other caregivers are meeting quality standards.