Accountable Care Organizations - CMS Solutions

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. CMS Solutions offers in-depth, comprehensive transformative guidance.

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.
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Quality In Healthcare

    AchieveQI
        Patient-Centered Medical Home (PCMH)
        Accountable Care Organizations (ACO)
    Healthcare Data & Analytics
    Quality Payment Program (QPP)
        Merit-based Incentive Payment System (MIPS)
            Advanced Alternative Payment Models (AAPM)

Medicare Offers Several ACO Programs

    Medicare Shared Savings Program  – 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

NQCA ACO Aredditation

A Roadmap For Success

There is no requirement to achieve the highest level of accreditation immediately. Instead, NCQA’s ACO Accreditation provides a roadmap for provider organizations to demonstrate their capability to function as ACOs over time.
Improve Continuity of Care

Use the NCQA standards to identify gaps in treatment and improve areas that need improvement.
Standardize Care

Use the NCQA standards to create efficiencies for your staff and set expectations for care.
Become an Attractive Partner

More than 15,000 primary care sites in the United States have been recognized for delivering high-quality, patient-centered care. More than 500 health plans have earned NCQA Accreditation. These organizations are looking for trusted partners in treating patients. The NCQA seal demonstrates your commitment to patient-centered care and continuity of care.
Show Patients Your Commitment to Quality

Display the NCQA seal to show patients and your community that you have a commitment to providing high-quality, patient-centered care.
Reduce Waste. Lower Costs.

Improving accountability in your organization and continuity of care helps reduce waste in the health care system, such as duplicated procedures and unnecessary readmissions or hospitalizations.

As the concept of healthcare value becomes more prominent, healthcare providers will increasingly need to focus on the whole patient or on populations of patients, encouraging and requiring teamwork among clinicians across specialties, as well as coordination among clinical care units and healthcare organizations of all types across the continuum of care (e.g., physician groups, hospitals, health systems, payers, and vendors).

The Centers for Medicare and Medicaid offer a number of options to providers seeking ACO participation. CMS Solutions provides guidance and assistance to providers through the entire ACO application and submission process:

    Selection of measures
    Data Collection
    Data Analysis
    Program Application
    Data Submission