Accountable Care Organizations (ACOs) are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to the Medicare patients they serve. Coordinated care helps ensure that patients, especially the chronically ill, get the right care at the right time, with the goal of avoiding unnecessary duplication of services and preventing medical errors. When an ACO succeeds in both delivering high-quality care and spending health care dollars more wisely, it will share in the savings it achieves for the Medicare program.
ACO Programs at CMS
Medicare offers several ACO programs, including:
- Medicare Shared Savings Program (cms.gov) - For fee-for-service beneficiaries
- ACO Investment Model - For Medicare Shared Savings Program ACOs to test pre-paid savings in rural and underserved areas
- Advance Payment ACO Model - For certain eligible providers already in or interested in the Medicare Shared Savings Program
- Comprehensive ESRD Care Initiative - For beneficiaries receiving dialysis services
- Next Generation ACO Model - For ACOs experienced in managing care for populations of patients
- Pioneer ACO Model - Health care organizations and providers already experienced in coordinating care for patients across care settings
- Vermont All-Payer ACO Model - Effort to transform healthcare for Vermont's population
Case Studies
- Reliance Healthcare’s Emergency Department Care Coordination Program (PDF) (June 2021)
- OneCare Vermont ACO: Innovation Fund (PDF) (June 2021)
- Nebraska Health Network's Data Management System for Improving Quality and Reducing Costs (PDF) (January 2021)
- Fresenius Kidney Care's Home Dialysis Program (PDF) (January 2021)
- UCSF Health's Care At Home Program (PDF) (January 2021)
- OneCare Vermont ACO: Community Care Coordination Program (PDF) (January 2021)
- Keystone ACO's Health Navigator Program to Identify and Close Care Gaps (PDF) (February 2020)
- Atlantic Dialysis Management Services' Patient Navigator Program (PDF) (February 2020)
- Center's for Dialysis Care's Patient Advisory Committees (PDF) (February 2020)
- Integra Community Care Network's Approach to Advance Care Planning (PDF) (November 2019)
- Silver State ACO's Provider Engagement Strategy (PDF) (November 2019)
- Southwestern Health Resources ACO Three-Day Rule Waiver: Approach to Communication and Implementation (PDF) (November 2019)
- Atrius Health: Improving Behavioral Health Care for Medicare Beneficiaries (PDF)
- Bellin Health Partners: The Evolution of Annual Wellness Visits (PDF)
- UnityPoint ACO's Home Visit Program (PDF) (July 2019)
- Boulder Valley Care Network's Provider Engagement Strategy (PDF) (July 2019)
- Coastal Medical's Leadership Academies: Investing in Staff Development and Collaboration (PDF) (July 2019)
- Henry Ford Accountable Care Organization's Beneficiary Engagement Strategy (PDF)
- Montefiore Accountable Care Organization's Provider Engagement Strategy (PDF)
- Partners HealthCare ACO and the Three-Day Rule Waiver: Implementation Approach and Lessons Learned (PDF)
- Rocky Mountain ACO's Approach to Care Coordination in Rural Areas (PDF)
- Rogosin Institute's Initiative to Promote Health Literacy (PDF)
Toolkits
- Operational Elements Toolkit (PDF) (June 2021)
- Beneficiary Engagement Toolkit (PDF)
- Care Coordination Toolkit (PDF)
- Provider Engagement Toolkit (PDF)
- Care Transformation Toolkit (PDF) (January 2021)
Tip Sheet
A series of three Accelerated Development Learning Sessions were held in select cities across the country. Additional information on each Session can be accessed below:
- ACO: Accelerated Development Learning Sessions - For existing or emerging Accountable Care Organizations (ACOs) to develop a broad and deep understanding of how to establish and implement core functions to improve care delivery and population health while reducing growth in costs.