Accountable Care Strategy

The Accountable Care Act (ACA) offers new tools and resources to help improve healthcare. In an effort to improve health, improve the quality of care, and lower costs, the ACA provides framework for accountable care organizations (ACOs) and ACO programs such as the Pioneer ACO Model and Advance Payment Initiative.

What are your goals for joining an ACO?

The most important item to consider is how you can position your practice for the future of accountable care. Ask yourself several questions — what are the goals of my practice? Do I have a three- to five-year operating or growth plan? Consider the various financial and strategic incentives to joining an ACO. Will you have access to bi-directional data exchange and interoperability? Are the agreements binding or non-binding?

Begin by assessing the EHR, interoperability and overall technology infrastructure of your practice. Check specific Medicare beneficiary patient volume and be aware that patients can opt in or out of the accountable care organization on a voluntarily basis. Begin engaging peers, associations, payers, employers and health systems in your community to see what they are planning. There could be an ACO forming near your practice

Identify CMS, private payer or combined care coordination/ACO opportunities as well. Remember that private payers are empowered to form ACO entities as well. Most importantly, don’t wait; accountable care organizations, accountable care and “at-risk” communities are forming today around the country and it’s important to ensure you are on the bleeding edge.

Medicare Shared Savings program (MSSP) ACOs: