Current List of ACOs
Accountable Care Organizations, or ACOs, are all about providing the best types of care for patients with Medicare while simultaneously helping to lower the cost of healthcare. They consist of a coordinated group of doctors, hospitals and various types of medical providers who work together for the benefit of the patients they serve, allowing them to get the right care when they need it.
There are hundreds of ACOs to choose from, some more popular than others. If you’re a Medicare patient or have a loved one on Medicare, it may be overwhelming to jump into the world of ACOs, especially when you might not know a lot about them. When choosing the right organization, you need to take into account your medical situation, any specific illnesses you currently have and what you’re looking for immediately as well as in the future.
Don’t be afraid to ask around and read reviews to decide what’s best for you.
List of ACOs in the U.S.
When doctors run on the pay-for-service model of healthcare, it can often feel like they aren’t taking the time to learn about each patient. At the same time, appointments can end up feeling rushed and impersonal.
The difference with an ACO is that the providers take the time to learn about your medical history and your specific needs to develop a healthcare plan that’s customized for you.
The good thing about ACOs is that the participating organizations can see significant financial benefits. This makes it easier to use those to better improve the quality of care offered to Medicare beneficiaries.
It’s important to note, there were Pioneer ACO models, but they ended in 2016, transiting into Shared Savings and Next Generation. In 2016, when the model ceased, there were nine remaining Pioneer ACOs.
There are a few other types of ACOs that you’ll need to know about.
Shared Savings was where ACOs first started, as it was a huge initiative to have healthcare providers focus more on the value of service they’re giving, rather than how many patients they see. The purpose was to organize the healthcare professionals so they could provide patients with high-quality care for patients.
The good thing about Shared Savings ACOs, also known as MSSPs, is that organizations can choose from numerous payment tracks. As of 2018, there are 561 Shared Savings ACOs in the United States.
Next Generation ACOs
Next Generation ACOs are designed to have more experienced ACOs take higher financial risks to lower the cost of provided services and to have a better patient outcome while offering higher rewards. This type of ACO provides a Merit-Based Incentive Payment System (MIPS) and an Advanced Alternative Payment Model, or APM.
This model offers tools to patients to improve their quality of care such as home visits, skilled nursing facilities, post-discharge home visits and telehealth services. As of 2018, there were 58 Next Generation Model ACOs.
Comprehensive End-Stage Renal Disease Care Model (CEC)
This model shares the highest level of financial risks than the others. CEC includes kidney care professionals, nephrologists and dialysis facilities who specialize in end-stage renal failure.
Dialysis organizations with less than 200 facilities can receive Shared Savings payments, but they’re not liable for the shared losses. As of 2017, there were 37 CEC ACOs.
Finding the Top Performing ACOs
If your current health care provider chooses to be part of an Accountable Care Organization, you’ll be notified. If you’re currently in search of a new doctor or a specialist, you can ask them if they’re part of an ACO.
Another way you can find the top performing ACOs in your area is by visiting the CMS website. It breaks the ACOs down by state, allowing you to see which ones are available in your geographical area.
If you have trouble determining which one would be best for you, you can always contact your local Medicare office to help you narrow down your options.
Some of the leading ACOs include Accountable Care Options, Alegent Health Partners, Essential Health, Dignity Health, and OneCare Vermont.
Finding Medicare ACO Reviews
When determining which ACO you want to go with, it’s necessary to perform extensive research to figure out what you’d have to benefit from choosing it. You would still be able to see health care providers outside of the ACO network, but the goal is to stay in it as much as possible for quality and consistent care.
Finding honest reviews on the ACOs in your state is as easy as a quick internet search. Don’t be afraid to dig around and read everything you can. This is the future of your healthcare, so it’s something you do want to take seriously.
You’re not only going to want to look at what other people are saying about them, but you’re going to need to know everything they can offer you now and in the future. While one ACO may work for a friend, you really do need to find the one best-suited for you and your needs.
There are always going to be mixed reviews about everything, especially when it comes to healthcare. This is why it’s important to take time to compare the different healthcare providers in your area.
Finding ACOs by State
ACOs will vary in each state, and currently, not all states have Accountable Care Organizations, but many are pursuing them.
There’s a handful of ACOs that have done exceptionally well and are worth learning more about.
Atrius Health in Newtown, Massachusetts
This ACO follows the Next Generation Model and in 2016, it was ranked number 1 for its quality scores at the conclusion of its first year established under the Pioneer model. Some of the main participants in this ACO include Atrius Health’s Dedham Medical Associates, Boston-based Harvard Vanguard Medical Associates and Quincy.
What’s notable is that Massachusetts became the first state to implement the all-payer standards for quality healthcare.
Banner Health Network in Greeley, Colorado
The Banner Health Network consists of approximately 300 primary care physicians and specialist serving northern Colorado. This network includes physicians, hospitals and ASCs and is determined to give coordinated care.
Dartmouth-Hitchcock in Lebanon, New Hampshire
To gain experience in the Pioneer model and the Shared Savings program, Dartmouth-Hitchcock ACO contains around 45 organizations nationwide. It participates in the Next Generation ACO model and includes 19 nursing facilities and 4 clinics to serve around 42,000 Medicare beneficiaries.
All of the financial savings are reinvested to improve the health of the population, offering a higher level of care.
Beaumont Accountable Care Organization in Southfield, Michigan
This network includes professionals in the Beaumont Health hospitals in an effort to provide physicians a chance to share in savings while improving patient healthcare. It’s generated an impressive $22.5 million in gross savings during 2017.
For 5 years, Beaumont ACO has achieved a significant amount of savings and has continued to meet the CMS quality financial targets.
Rio Grande Valley ACO Health Providers in Donna, Texas
This ACO covers four counties spanning across south Texas and Passaic County, New Jersey. It’s a Track 3 Medicare Shared Savings Program model and reportedly had $12.6 in shared savings in 2015. This ACO was recognized for its performance when it received a Darwin Health Honored RFC ACO in 2016.
Carolinas HealthCare System ACO in Charlotte, North Carolina
Also known as Atrium Health, this ACO is considered private, and partners with BlueCross BlueShield of North Carolina. Carolina’s HealthCare System ACO is a participant in MSSP and aims to have medical professionals communicate better with patients so they can offer optimal care.
Robert Wood Johnson Partners in New Brunswick, New Jersey
This ACO is a physician-led network with more than 750 participating doctors. It’s a collaboration between Robert Wood Johnson University, Rutgers University and Robert Wood Johnson Health System. It uses the Track 1 Medicare Shared Savings Program ACO model. It reportedly had around $3.9 million in shared savings in 2016.
UnityPoint Accountable Care in West Des Moines, Iowa
This ACO contains over 1,000 physicians and 400 advanced care providers and is part of the CMS Next Generation ACO model. They reportedly had $10.5 million in shared savings in 2016 alone, with $18.2 million in commercial contracts.
This ACO is a collaboration between Iowa City-based University of Iowa Health Care and several other organizations.
West Florida ACO in Trinity, Florida
This ACO was one of the first ones accepted in Medicare’s Shared Savings Program in 2012. This network includes internal medicine, family medicine, comprehensive health checks and family medicine for beneficiaries of Medicare. What stands out about this ACO is that it provides beneficiaries with at 24/7 call service which allows them to receive timely service. Currently, there are around 60 practices in this ACO and serve around 17,749 Medicare beneficiaries.
What stands out about this ACO is that it provides beneficiaries with at 24/7 call service which allows them to receive timely service. Currently, there are around 60 practices in this ACO and serve around 17,749 Medicare beneficiaries.
Southwestern Health Resources in Dallas, Texas
This ACO is a collaboration between the Dallas-based UT Southwestern Medical Center, Southwestern Health Resources, and Arlington-based Texas Health Resources. Since January 2017, it’s been part of the Next Generation ACO model and it includes 31 hospitals, 3,000 physicians, and over 650 other healthcare locations.
Southeastern Health Partners in Greensville, South Carolina
This is a Track 1 MSSP ACO which includes Anderson S.C. based AnMed Health, S.C.-based Saint Francis Hospital, Spartanburg S.C. Medical Center and other healthcare providers. They serve approximately 59,544 beneficiaries in North and South Carolina, and strive to improve coordination and population growth.
To find out more about the ACOs in your state, please click here.