The Affordable Care Act established Accountable Care Organizations (ACOs) as voluntary groups of physicians, hospitals, and other health care professionals who accept responsibility for the overall quality, cost, and care of a defined group of Medicare beneficiaries. When Medicare saves money on services because a patient population is healthy, it splits the savings with participating ACOs. And Medicare is not the only payer with a shared savings program; most private payers now offer value-based contracts.
The catch is proving you kept patients healthy and saved the payer money, which can be a challenge. This resource center answers frequently asked questions and provides current information on ACOs and steps you can take to get involved.
Why Should I Care?
Physicians have for decades earned a living based on caring for the sick. But in the new world of health care, professionals will earn money based on whether they can keep their patients healthy — a value-based payment system.
Physicians have for decades earned a living based on caring for the sick, but will more often will be paid based on whether they can keep their patients healthy. In a system that increasingly includes more “accountable care” payment contracts, this guide arms you with information you need as you consider joining or forming an ACO. Log into the TMA Education Center using your TMA website username and password to automatically receive member pricing on CME.
What exactly is value-based care and shared savings?The basic concept is simple: if a physician network/ACO can successfully manage the health of its overall patient population, achieve better clinical outcomes, and reduce total health care spending, patients fare better and physicians share in the cost savings.
Learn about the new company created by the Texas Medical Association (TMA) to bring physicians the technology and expertise needed to take advantage of new health care payment models.
TMA launched the Accountable Care Leadership Program hand in hand with TMA PracticeEdge, a physician services organization designed to support physicians in taking advantage of new payment models.
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Competing in the Marketplace - AMA Resource
The Payment Reform Glossary, a free resource developed by the Center for Healthcare Quality and Payment Reform
Effects of Health Care Payment Models on Physician Practice in the United States - RAND Corporation, 2015
Providers, Payers Need to Mend Relationships to Make Value-Based Care System Successful - Modern Healthcare
Independent Physicians: Meet The Resources Your System-Affiliated Peers Have Had - DHealthcare Daily
Can Physician-Led ACOs Keep Physicians Independent? - Healthcare Dive
Announcing TMA PracticeEdge
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