San Francisco Marin Medical Society Blog

ACO Rollout Continues With 89 New Networks



The next round of accountable care organizations (ACOs) is out at last.Accountable Care Organizations

 

The Centers for Medicare and Medicaid Services announced the selection of 89 new ACOs on Monday, including John Muir Physician Network in the East Bay. This is more than triple the number of ACOs selected in the previous round. As of July 1, the newly anointed networks became responsible for providing better, cheaper care to 1.2 million seniors on Medicare.

 

The Medicare ACO program was created under the 2010 federal health law, and there had been some worry among health care providers about what would happen to the program if the Affordable Care Act was ruled unconstitutional.

 

Now that the law has been upheld by the Supreme Court, Medicare ACOs that have sprouted up throughout the country can proceed with more confidence.

 

ACOs are networks of hospitals and doctors that receive financial incentives to coordinate care for a defined population of patients.  The idea is to improve the quality of care while lowering costs, for example, by making sure that patients with chronic conditions like diabetes and high blood pressure get the preventive care that keeps them out of the hospital.

 

The ACO model has also become popular throughout the private insurance world as well, and almost every major insurer is sponsoring its own ACOs for patients who are not on Medicare.

 

“Better coordinated care is good for patients, and it saves money,” said HHS Secretary Kathleen Sebelius in a press release.

 

More than half of the ACOs announced in July are “physician-driven organizations serving fewer than 10,000 beneficiaries, demonstrating that smaller organizations are interested in operating as ACOs,” according to the HHS announcement. The majority of the ACOs announced in April were also physician-led organizations, which may help quell concerns that ACOs will become hospital behemoths that dominate certain communities, making it difficult for insurers to negotiate low rates for consumers.

 

New ACOs will now be accepted annually, with the next cohort beginning in January 2013. CMS says that 400 systems have already expressed interest in applying.

 

Click here for the CMS press release about new ACOs on July 9, 2012.

 

Click here for the full list of the 89 new ACOs announced by CMS on Monday.

 

Click here for a list of FAQs about ACOs.


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