What is An ACO?

ACOs: Accountable Care Is Coordinated Care

An Accountable Care Organization (ACO) is a group of doctors and other healthcare providers who agree to work together with the Centers for Medicare & Medicaid Services (CMS) to give Medicare Fee-For-Service Beneficiaries the best possible care. ACOs may take different approaches to giving Medicare Fee-For-Service Beneficiaries’ coordinated care. Some ACOs may have special nurses that help set up appointments or make sure Medicare Fee-For-Service Beneficiaries medications are in order when they enter or leave a hospital. Other ACOs may help doctors get equipment for beneficiaries to monitor medical conditions better at home, if needed.

Most ACOs use advanced systems that let them more carefully track patients’ care, and make sure that participating doctors have the most up-to-date information about their Medicare Fee-For-Service Beneficiaries’ health. The goal of the ACO is to support doctors and other healthcare providers in caring for their Medicare Fee-For-Service Beneficiaries. For beneficiaries, this means doctors communicate better with each other and Medicare Fee-For-Service Beneficiary’s can avoid having duplicate tests or answering the same questions over and over. Working together, healthcare providers can do more to follow each Medicare Fee-For-Service Beneficiary’s health, ensuring the best possible care.

Doctors and other healthcare providers choose to participate in an ACO because they’re committed to providing Medicare Fee-For-Service Beneficiaries with a better care experience. They may also be rewarded for offering better, more coordinated care. If a doctor chooses to participate in an ACO, the doctor’s Medicare Fee-For-Service Beneficiaries will be notified, either in person or by letter.

An ACO isn’t the same as a Medicare Advantage Plan or Health Maintenance Organization (HMO). For those who are covered by Medicare benefits, services, rights and protections won’t change. Medicare fee-for-service beneficiaries still have the right to use any doctor or hospital that accepts Medicare at any time.