Reimbursement

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Medicare Adds New ACOs

April 9, 2015

 

Medicare’s ACO program continues to grow with 424 accountable care organizations now in operation, having added 89 new ones in 2015. The number of patients covered has grown from 5.6 million to 7.8 million during the past year.

 

The new ACOs all use the shared savings model, which allows them to share in any savings arising from coordinated care, but avoid sharing any losses. Also, of the 424 total ACOs, 19 are pioneer ACOs, as compared with 23 a year ago. Pioneer ACOs differ from shared-savings ACOs in that they are at risk for any potential losses.

 

The Philips ACO map, which is available on the main page of the Reimbursement Simplified website, has been updated to reflect the new ACOs, including their location, states they cover, contact information, and type of ACO model. Click here to see the CMS list of 89 new ACOs.

 

Other developments underway in Medicare ACOs:

 

  • Medicare introduced a new variation on ACOs which will go into effect in January 2016.This would allow ACOs to take on more financial risk/reward and establish a more predictable revenue stream. Read more.
  • Medicare also is expected to release soon a final regulation outlining changes and adjustments in the ACO program.The changes were proposed in January, 2015, and would provide ACOs with greater flexibility and potentially greater rewards. Read more.