ACOs Defined, but Many Questions Remain

The accountable care organization (ACO) is an element of health care reform that is quickly gaining momentum. For many people, these organizations hold great potential for playing a significant role in reducing the overall cost of health care and improving clinical quality and patient satisfaction.

By definition, an ACO is a group of health care providers that work together to manage and coordinate care for a defined patient population. As part of managing and coordinating care, the ACO also accepts responsibility for improving the quality of care provided, while reducing costs at the same time.

The definition of an ACO is understandable; however, how they’ll operate is an elusive concept. It’s difficult to comprehend how different providers with their own missions, visions, and leadership teams will come together to function as a single unified structure without walls.

Under the “Shared Savings Program” of the Patient Protection and Affordable Care Act (PPACA), the provisions for ACOs are scheduled to begin no later than January 1, 2012. However, many of today’s questions about the requirements for ACOs, such as measures of quality, assignment of beneficiaries, and incentive sharing, won’t be answered until the Department of Health and Human Services (HHS) fills in the details. Other key operating issues, including leadership, capital investments, technology needs, budgeting and forecasting, etc., will likely work themselves out as providers start forming ACOs.

While many people expect ACOs will play a significant role in improving the American health system, there are a lot of unanswered questions. Despite the unknowns, I believe there are some essential characteristics each ACO will need to be successful. Download our white paper titled, The Revolving Role of ACOs in Reforming Health to learn about:

• How ACOs might operate
• The requirements outlined in the health reform act
• How these organizations are expected to differ from HMOs and PPOs
• The key principles of an ACO and the common questions

What are your biggest questions and concerns when it comes to the operation of ACOs?