What is an ACO?

ACOs, or accountable care organizations, are defined by the Center for Medicare and Medicaid Services (CMS) as “groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to their Medicare patients.”

ACOs can be group practice networks (or other collaborations between medical providers and hospitals), rural health centers, critical access hospitals, federally qualified health centers, and home health networks who see medicare fee-for-service patients.

In order to maintain status as an ACO, practices must report evidence of having met 33 quality standards that fall under the domains of patient/caregiver experience, preventative care measures, continuity of care, patient safety, and care of at-risk populations- elderly/frail health patients.

How can an EMR help my ACO?

Accountable care organizations are required to provide high-quality, comprehensive medical care for their patients at a low cost.  An EHR that allows providers to document their patient’s condition quickly and clearly improves continuity of care, providing each provider with improved insight on their patients’ condition, and can help cut patients’ medical expenses by preventing duplicate tests or services. With IMS’ customizable visit note templates, intuitive reports, visual dashboard display, and ability to communicate with other EHR systems, you can meet the needs of all providers in your organization and provide high-quality, low-cost care to your patients.

Why IMS?

• All-in-one suite for documentation, prescribing, document management, lab/diagnostic ordering, and billing
• Ability to customize for each provider in your practice reporting functions that allow for management of specific patient populations within a practice
• Secure chart exporting and faxing capabilities for ease of data sharing
• Ability to communicate with your patients through the patient portal and automatically remind them of appointments by e-mail, text, or phone
• Allow practice managers and partners to report on and share important information about the financial health of the organization

Am I eligible to become an ACO?

Those who would like to participate in accountable care organization programs must:

1. Agree to be responsible for providing high-quality, low-cost care for Medicare fee-for-service beneficiaries for three years
2. Be structured such that the organization is legally allowed to receive and distribute Medicare payments to participating providers
3. Have at least 5,000 Medicare fee-for-service beneficiaries and an adequate number of primary care providers for those patients
4. Implement a leadership and management program
5. Report proof that the organization provides high quality evidence-based care, implement measures to engage patients, send data on cost measures, and provide good continuity of care with other providers
6. Provide evidence that the organization provides patient centered care
7. Continuously evaluate the specific health needs of the organization’s individual patient population
8. Exempt itself from other Medicare shared savings programs.

A smart financial decision:

Becoming an ACO can allow you to receive monetary rewards for reporting on cost-cutting and quality care assurance measures, many of which are already standard-practice.  It is possible that physicians that do not sign on with ACOs may see decrease in their Medicare reimbursement or be penalized, so starting now is key.