Accountable Care Organizations (ACO) Katharine Rebolledo, MBA University of New Mexico Department of Family and Community Medicine

 Eric Tobiason – Dept. Administrator, Univ. of Washington  Michael Andrade – Dept. Administrator, Rutger s Robert Wood Johnson Medical School  Sandra Kamentz, MD – Vice Chair Clinical Care, DFM Univ. of Wisconsin Panel Discussion

 What is an ACO?  What is the Goal of an ACO?  What ACO Medicare Programs are Offered?  Why did Congress include ACOs in the Law?  Benefits of Accountable Care.  How ACOs Work.  How are ACOs Paid?  Panel Discussion Learning Points

 Groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to their Medicare patients. What is an ACO? Source: Source:  A network of doctors and hospitals that shares financial and medical responsibility for providing coordinated care to patients in hopes of limiting unnecessary spending. At the heart of each patient’s care is a primary care physician.

 The goal of coordinated care is to ensure that patients, especially the chronically ill, get the right care at the right time, while avoiding unnecessary duplication of services and procedures. What is the goal? Source:  When an ACO succeeds both in delivering high-quality care and spending health care dollars more wisely, it will share in the savings it achieves.

 Medicare Shared Savings Program—a program that helps a Medicare fee-for-service program providers become an ACO.  Advance Payment ACO Model—a supplementary incentive program for selected participants in the Shared Savings Program.  Pioneer ACO Model—a program designed for early adopters of coordinated care. No longer accepting applications. What ACO Medicare Programs are Offered? Source:

 As lawmakers searched for ways to reduce the national deficit, Medicare became a prime target. Why Did Congress Include ACOs in the Law? Source:

Benefits of Accountable Care Source:

 Seamlessly share information.  Providers can choose to be at risk of losing money or they can enter the program with no risk at all.  ACOs are projected to save Medicare up to $940 million in their first four years. How ACOs Work Source:

 Medicare traditional fee-for-service payment system  ACOs don’t do away with fee for service  What if an ACO is unable able to save money?  Are there penalties? How are ACOs Paid? Source:

 Eric Tobiason – Dept. Administrator, Univ. of Washington  Michael Andrade – Dept. Administrator, Rutger s Robert Wood Johnson Medical School  Sandra Kamentz, MD – Vice Chair Clinical Care, DFM Univ. of Wisconsin Panel Discussion

Final Thoughts/Comments