In 2006, three years before the introduction of the Affordable Care Act (ACA), Dr Elliott Fisher, the Director of the Center for Health Policy Research at the Dartmouth Medical School, introduced the concept of an Accountable Care Organization (ACO).
The idea was simple — a group of doctors, hospitals, and other health care providers come together, voluntarily, to provide high quality care to their Medicare patients. Many recipients of Medicare need special and timely attention, and the coordinated care ensured that their needs were met. Moreover, the savings enjoyed by the ACO is then shared with the Medicare program.
The Centers for Medicare and Medicaid Services website lists several options for ACO programs:
- Medicare Shared Savings Program (cms.gov): For fee-for-service beneficiaries
- ACO Investment Model: For Medicare Shared Savings Program ACOs to test pre-paid savings in rural and underserved areas
- Comprehensive ESRD Care Initiative: For beneficiaries receiving dialysis services
- Next Generation ACO Model: For ACOs experienced in managing care for populations of patients
- Pioneer ACO Model: Health care organizations and providers already experienced in coordinating care for patients across care settings
In order to fully educate those interested in participation in an Affordable Care Organization, the CMS holds conferences called Accelerated Development Learning Sessions (ADLS). They offer webinars as well, and later release the recordings on their website for further dissemination of information.
If you’re interested in becoming a participant in an ACO or starting one yourself, the ADLS is the best place to start. These sessions are designed to assist executive leadership teams, either from current or newly forming ACO entities. They offer help developing an action plan for fulfilling crucial ACO functions, provide information targeting your understanding of your organization's readiness to become an ACO, and help you identify personalized goals for improving healthcare delivery, improving health, and reducing burgeoning costs.
As a final point, know that it’s not necessary to become an Affordable Care Organization simply because you’re a healthcare provider. The CMS encourages providers to make the move towards becoming an ACO, and they are willing to work with organizations at any stage in their development. However, it is stated explicitly on their website that becoming an ACO is purely voluntary.