Physician-only accountable care organizations (ACO), such as urgent care clinics and ambulatory surgical centers, have significant flexibility to contract with allied providers to build the ACO’s network as a new enterprise.
- A strong primary care physician base, a willingness to invest in the infrastructure needed to create patient engagement, care coordination to manage at-risk populations and a culture of effective communication; these are critical to an ACO’s success.
- The financial and quality successes of ACOs have greatly improved. An increasing proportion of ACOs have generated savings above their minimum savings rate each year.
- Experienced ACOs have seen success in early detection/early intervention by developing a stable of allied providers to steer patients to the appropriate sites of care.
- Physician-only ACOs have obtained management, information technology, care coordination, and compliance infrastructure thanks to third party vendors accepting contingent payment from a portion of potential shared savings.
- Health insurers and private equity funded management companies have recognized that a properly supported physician ACO can achieve improved quality and lower costs than independent physicians or mere contracting networks.
Summary of ACO final rule
Read an overview of a final rule from the Centers for Medicare & Medicaid Services, “Medicare Shared Savings Program: Accountable Care Organizations – Pathways to Success Final Rule." This summary includes a chart comparing the previous Medicare Shared Savings Program ACO tracks to the ACO tracks in the final rule.