Editor’s Note: BHM assists organizations making the transformation to Accountable Care with strategic planning that allows you to successfully convert to a quality driven organization.
The number of Accountable Care Organizations (ACOs) in the U.S. is growing rapidly, causing major shift in the healthcare landscape. ACOs are provider lead organization with a strong primary care base. What makes them different from other healthcare models is that ACOs are collectively accountable for quality, costs and the full continuum of care for their patients. Encouraged by the Affordable Care Act, this type of shared-risk model, which also falls under value-based, is becoming a good option for many providers.

It is predicted that by 2020 ACOs will cover approximately 70 million people. Therefore, organizations that can effectively manage change and find success in this type of model will gain significant early adopter advantages.

The NCQA, one of the nation’s largest accrediting bodies, has rolled-out an Accountable Care Organization Accreditation program. The ACO Accreditation evaluates organizations on quality, efficiency and patient centered care, as well as other important measures expected from ACOs. The accreditation acts not only as a badge of excellence for that ACO but will acts as a road-map for organizations making the transition.

The NQCA Evaluate ACOs on these categories…

Patient-Centered Primary Care
Care Management and Coordination
Performance Reporting
Quality Improvement
Access to Providers
Structure and Operations Patient Rights and Responsibilities

Definition of an ACO from the NCQA

“Accountable Care Organizations (ACOs) are provider-based entities that have come together with the shared goal of taking responsibility for improving quality of care and reducing cost growth for a population. ACOs have the potential to achieve better quality at lower cost by aligning incentives to promote coordination and transform health care delivery across the spectrum of providers who participate in a patient’s care¹.”

ACO Benefits

ACOs are built to focus on patient-centered care. They ensure that patients are getting quality care that they want and the way they want it¹.

ACOs are a great options for providers because they allow providers to collaborate and share risk with an end goal of providing better quality care.

What about payers? According to the NCQA, “ACOs align the clinical and financial incentives of their providers. Clinicians work together seamlessly to coordinate care for patients, with the goal of simultaneously improving quality and reducing costs. The ACO model enables plans and purchasers to increase the value of health care dollars¹.”

Why Accreditation Matters

  • Mark of Excellence
  • Drives Efficiency
  • Builds Trust & Recognition
  • Mark of Excellence
  • Organizational Improvement
  • Competitive Advantage

¹ NCQA ACO Accreditation – Learn more about the NCQA ACO Accreditation program by clicking here.