An Accountable Care Organization is a collective of health care providers and health care-providing enterprises that collaborate for the enhanced welfare of Medicare-covered patients.
Terms and Variations
The terms of an ACO entail that when both its treatment habits and its capital management habits are ideal, the Medicare program will allow it to keep a portion of the savings that it helped to generated through smart management and thoroughness. There are a number of differently-structured ACO programs with unique terms, including the Pioneer ACO Model, the Advance Payment ACO Model, and the Medicare Shared Savings Program.
Pioneer ACO Model
The Pioneer ACO model, currently no longer accepting new applicants, is aimed at health care providers who opted into coordinated care earlier than others. The program is best-suited for organizations that have already gained a significant amount of experience in successfully providing coordinated care in a diverse range of different conditions.
Ideally, the program can help to optimize the synchronization of provider incentives, which can directly work in tandem with private payers. In the best case scenario, the rate at which provider programs with shared savings payment models can transition into population-based payment models can accelerate.
Advance Payment ACO Model
The Advance Payment Model is designed to provide incentives as supplementary program for providers that are either rural or physician-based. Like all ACO model programs, the health providers involved within it will come together in order to potentially increase the quality of coordinated health care provided to their patients.
In this particular program, there is the disbursement of both a monthly payment and an upfront payment as well. With the monthly and upfront and monthly payments, providers have the privilege of being able to invest in their coordination infrastructure with a better degree of security.
Medicare Shared Savings Programs
In the Medicare Shared Savings Program, providers who are currently involved in fee-for-service (FFS) programs have the ability to transition into an ACO model. In addition to “Medicare Shared Savings Program,” this model is also referred to as the “Shared Savings Program.” Section 3022 of the Affordable Care Act was the root the program’s establishment. Of all different programs to health care delivery, the Medicare Shared Savings Program is one of the newer approaches to be introduced.
Overall, the program has emerged as one of the most essential movements for health care delivery reformation through optimized coordination. The three key initiatives outlined by the beneficiary outcome strategies of the plan are to provide better individual care, create a better standard of health in the population at large, and to cut down on the costs of general health care expenses. Simply creating an ACO program is sufficient-enough grounds for all eligible suppliers, hospitals and providers to motion for involvement in the Shared Savings Program.
Conclusion
One of the the primary aims of an Accountable Care Organization is to ensure that all of the treatment it provides is as prompt as possible, ensuring that patients who suffer from chronic conditions are able to receive the help they require in a timely manner. Ideally, the collaboration of these hospitals, doctors and other health care providers will result in the highest quality of treatment for all Medicare patients put into their care.
