Accounting for Accountable Care Organizations

In this RapidInsight, we introduce ACOs and discuss how they are structured, which quality metrics are measured, how payments work, how risk is measured, and why it is pivotal that ACOs are successful.

Technology is also crucial to ACO development and success. We examine technologies ACOs need. In addition, we highlight opportunities in the ACO ecosystem for BPO providers, buyers and management consultants.

An ACO (accountable care organization) is an organization that provides care via physicians and other healthcare providers who are held accountable for the quality and cost of care to a specific population. If all providers within an ACO network are connected and share information effectively, transparency is increased, costs reduced, and increased quality achieved. To qualify as an ACO, the organization must agree to be accountable for all care delivered, have adequate participation by primary care physicians, report to Center for Medicare and Medicaid Services (CMS) the quality of care delivered and the costs, develop and define processes for outcome-based medicine, and coordinate care effectively.