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Accountable Care Organizations (ACO)

Understanding Accountable Care Organizations (ACO)

What are Accountable Care Organizations?

Accountable Care Organizations (ACOs) are groups of doctors, hospitals, and other healthcare providers who come together voluntarily to give coordinated care to the patients and populations they serve. By coordinating efforts, ACOs help ensure that patients, especially the chronically ill, get the right care they need without duplicating services.

The goal of collaborative care is to ensure that patients, especially the chronically ill, get the right care at the right time, while avoiding unnecessary service duplication and medical errors.

To lower costs and ensure consistently high-quality care, groups of physicians and hospitals are embracing value-based care delivery models and becoming Accountable Care Organizations (ACOs) to provide collaborative care. ACOs cover roughly 37 to 43 million patients nationally and accept financial risk for both the quality and cost of care.

When an ACO succeeds both in delivering high-quality care and spending dollars more wisely, it shares the savings it achieves from the Medicare program.

Medicare ACO programs

Medicare Shared Savings Program
A program that helps Medicare fee-for-service providers become an ACO

Advance Payment ACO Model
A supplementary incentive program for selected participants in the Medicare Shared Savings Program

Pioneer ACO Model
A program designed for early adopters of collaborative care (no longer accepting applications)


Requirements for ACO success

Collaborative care is not any one out-of-the-box or plug-and-play product or service. It is a very business- and staff-intensive concept framed and supported first by proper business planning and then by the optimal use of organizational, clinical, financial, and technical resources by knowledgeable staff. To achieve collaborative care, ACOs need a sustainable and versatile EHR solution.

The right tools, resources, and expertise

At NextGen Healthcare, we are committed to providing our clients with the tools, resources, and expertise they need to reach their ACO, meaningful use (MU), and Patient-Centered Medical Home (PCMH) goals. We provide infrastructure and solutions that enable the connectivity and interoperability required for success with the new care delivery and reimbursement models.

Taking on More Risk

The Centers for Medicare and Medicaid services announced a proposed rule that would make changes to Medicare's largest program for accountable care organizations. Read this white paper, which examines these proposed changes, discussing the significance for ACOs. 

Overcoming ACO obstacles

When pursuing ACO success, you may need to ask yourself:

  • How can our practice get a comprehensive view of the patient population?
  • How do we define practice success?
  • Is our practice prepared to meet regulatory requirements?
  • How does our practice measure, quantify, and report results?

With accessible interoperability from NextGen Healthcare, you can lay a foundation for the pathway to ACO success. Today's ACO models require providers to implement a solution that connects disparate systems to seamlessly exchange accurate, patient-specific data. Through real-time data exchange across multiple providers, you can dramatically advance care delivery, decrease costs, reduce errors, improve population health, and enhance operational, clinical, and financial outcomes for your practice.