An Overview of ACO Models

Many healthcare professionals wonder about the Accountable Care Organization (ACO) models that have been established by the Centers for Medicare & Medicaid Services (CMS). We have summarized the main ACO models below.

 

Medicare Shared Services Program.

This program otherwise known as (MSSP), is meant to establish coordination among providers and the beneficiaries to reduce costs. Those that are eligible to participate in this program are providers, hospitals, and suppliers.

 

Advance Payment Model.

This model is geared towards rural and physician-based providers who have come together voluntarily to improve coordination and health care for their patients. Under this model, the selected caregivers receive upfront and monthly payment that go towards investment in the infrastructure of coordinated care.

 

Pioneer ACO Model.

This model is appropriate for providers and health care organizations that are already familiar with coordinated care for their patients. Under this model, provider groups can move quickly from a shared savings payment model to a population-based payment model.

 

Through these programs, providers work in tandem with private payers by aligning incentives.
It is intended to improve quality and health outcomes for patients across the ACO, and achieve cost savings for Medicare, employers and patients.