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Entering an ACO Agreement? Know the Risks

First few Article Sentences

In an effort to reduce health care costs, the Affordable Care Act encourages providers, physicians, and hospitals to partner to better coordinate patient care. Known as accountable care organizations (ACOs), these payer-provider alliances are designed to deliver low-cost, high-quality care and avoid unnecessary duplication of services and medical errors.

To further promote ACO participation, the Centers for Medicare & Medicaid Services (CMS) is rewarding efficiency and improved patient management and experience by providing financial incentives and shared savings for outcomes such as reducing the length of hospital stays and using technology to improve communications. As a result, over the past 12 months, ACOs have experienced significant and steady growth and now cover between 37 million and 43 million patients in the United States, according to an August 2013 Leavitt Partners report. Before agreeing to participate in an ACO, however, there are risks to consider. Participating ACO members are bound by a contractual arrangement and jointly accountable for improving the quality and affordability of care, among other unique contract requirements. Therefore, it's important to understand the expectations of the contract, payment arrangements, and how to minimize the anticipated risks.

Pritchard, Chris


Moss Adams LLP

Accountable Care Organizations

June 3, 2015

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