Accountable Care Organizations
What is an Accountable Care Organization?
An ACO is a provider-led team of hospitals and doctors who have agreed to work together to deliver great care to a defined group of patients, and to make that care affordable. The ACO takes responsibility for improving care quality and slowing the growth of health care costs. This responsibility also may include financial risk.
Team members must agree to participate in efforts to measure and report on how well they perform and to be accountable to each other to improve the cost, quality and patient experience. And, if performance meets agreed upon targets or improves, the team members can earn bonuses.
CHI Health Partners manages these ACOs:
An improved health care experience
- Help members select a primary care doctor
- Smooth care transitions between providers and facilities
- Explanation of discharge instructions and medications
- Nurse care coordinators provide support to high-risk patients with personalized care plans
- A care team enabled with technology and information supports members between office visits
Supporting improved patient outcomes with data sharing and analysis
- Risk-stratification allows the ACO to reach out to members most likely to need special attention, which improves care quality
- Identification and monitoring of efficiency metrics, such as inpatient admissions and length of stay, ED use, and prescription patterns
- Quality measures enable the ACO to track performance against clinical quality targets
- Financial incentives for achieving quality and efficiency goals
Potential for cost savings
- The ACO model has proven to be successful at reducing costs for CHI Health's employee health plan
- For the Aetna Whole Health CHI Health Accountable Care Network ACO, health care savings will be specific to each employer, with the potential to save up to 15 percent over other similar competitor health plans