Download | November 30, 2012

Commercial ACOs Fact Sheet

Source: Greenway Health

On a parallel track with the Medicare Shared Savings Program, private/commercial ACOs are forming and gaining traction across the country. These entities differ from Medicare ACOs in key ways in that highlight their independence from government oversight.

  • The private sector is outpacing Medicare in terms of developing ACOs by a 4-­‐to-­‐1 margin
    • 162 private ACOs exist in 45 states and the District of Columbia
  • At present, private ACOs typically exist in large metropolitan areas
  • In a private ACO model, providers work collaboratively together with each other and a payer to be responsible for the quality, care and cost of healthcare services to the ACO’s members
    • The ACO must provide a continuum of care in a real or virtually integrated care delivery system
    • The ACO must be of a sufficient size to provide adequate measurement numbers in terms of performance and expenditure measurement
    • The ACO must be able to design a provider-­‐payer contract that appropriately incorporates budget planning and shared savings distribution

Download this fact sheet from Greenway below to read more.

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