# ACO * **Definition:** Accountable Care Organization, a healthcare organization that ties provider reimbursements to quality metrics and reductions in the total cost of care, consisting of groups of doctors, hospitals, and other healthcare providers who come together to provide coordinated high-quality care to their patients. * **Taxonomy:** Healthcare Topics / ACO ## News * Selected news on the topic of **ACO**, for healthcare technology leaders * 5.7K news items are in the system for this topic * Posts have been filtered for tech and healthcare-related keywords | Date | Title | Source | | --- | --- | --- | | 5/23/2025 | [**CMS outlines tweaks to ACO REACH for 2026 performance year - Fierce Healthcare**](https://www.fiercehealthcare.com/regulatory/cms-outlines-tweaks-aco-reach-2026-performance-year) | [[FierceHealthcare]] | | 5/22/2025 | [**CMS shift sparks hope for high-needs ACO REACH extension**](https://www.modernhealthcare.com/policy/aco-reach-cms-cmmi-mehmet-oz-abe-sutton) | [[Modern Healthcare]] | | 4/29/2025 | [**Health care providers that work together save Medicare money**](https://medicalxpress.com/news/2025-04-health-medicare-money.html) | [[MedicalXpress]] | | 4/8/2025 | [**Organizational Factors Associated With Variation in Primary Care Providers in ACOs**](https://www.ajmc.com/view/organizational-factors-associated-with-variation-in-primary-care-providers-in-acos) | [[AJMC]] | | 3/27/2025 | [**10Bridge Announces Achievement of a Major Deployment Milestone within the Accountable Care Market**](https://finance.yahoo.com/news/10bridge-announces-achievement-major-deployment-143000661.html) | [[Yahoo Finance]] | | 2/6/2025 | [**ACON Investments Completes Sale of Vitalis - PR Newswire**](https://www.prnewswire.com/news-releases/acon-investments-completes-sale-of-vitalis-302370630.html) | [[PR Newswire]] | | 1/21/2025 | [**Lightbeam REACH ACO Clients Outperform Non-Lightbeam REACH ACOs by 45**](http://www.businesswire.com/news/home/20250121055853/en/Lightbeam-REACH-ACO-Clients-Outperform-Non-Lightbeam-REACH-ACOs-by-45/?feedref=JjAwJuNHiystnCoBq_hl-Q-tiwWZwkcswR1UZtV7eGe24xL9TZOyQUMS3J72mJlQ7fxFuNFTHSunhvli30RlBNXya2izy9YOgHlBiZQk2LOzmn6JePCpHPCiYGaEx4DL1Rq8pNwkf3AarimpDzQGuQ==) | [[Business Wire]] | | 1/21/2025 | [**Lightbeam REACH ACO Clients Outperform Non-Lightbeam REACH ACOs by 45**](http://www.businesswire.com/news/home/20250121055853/en/Lightbeam-REACH-ACO-Clients-Outperform-Non-Lightbeam-REACH-ACOs-by-45/?feedref=JjAwJuNHiystnCoBq_hl-RLXHJgazfQJNuOVHefdHP-D8R-QU5o2AvY8bhI9uvWSD8DYIYv4TIC1g1u0AKcacnnViVjtb72bOP4-4nHK5ieT3WxPE8m_kWI77F87CseT) | [[Business Wire]] | | 1/14/2025 | [**Medicare Accountable Care Organizations In 2023: Large Savings With Increasing Value-Based Programmatic Competition**](https://www.healthaffairs.org/content/forefront/medicare-accountable-care-organizations-2023-large-savings-increasing-value-based) | [[Health Affairs]] | | 12/12/2024 | [**Characteristics of Accountable Care Organizations' Preferred Skilled Nursing Facility Networks**](https://www.ajmc.com/view/characteristics-of-accountable-care-organizations-preferred-skilled-nursing-facility-networks) | [[AJMC]] | | 12/10/2024 | [**ACOs Using Lightbeam Solutions Report Record MSSP Savings in PY23, Driving ... - Morningstar**](https://www.morningstar.com/news/business-wire/20241210682108/acos-using-lightbeam-solutions-report-record-mssp-savings-in-py23-driving-cumulative-savings-beyond-3-billion-milestone) | [[Morningstar]] | | 12/10/2024 | [**ACOs Using Lightbeam Solutions Report Record MSSP Savings in PY23, Driving Cumulative Savings Beyond $3 Billion Milestone**](http://www.businesswire.com/news/home/20241210682108/en/ACOs-Using-Lightbeam-Solutions-Report-Record-MSSP-Savings-in-PY23-Driving-Cumulative-Savings-Beyond-3-Billion-Milestone/?feedref=JjAwJuNHiystnCoBq_hl-Q-tiwWZwkcswR1UZtV7eGe24xL9TZOyQUMS3J72mJlQ7fxFuNFTHSunhvli30RlBNXya2izy9YOgHlBiZQk2LOzmn6JePCpHPCiYGaEx4DL1Rq8pNwkf3AarimpDzQGuQ==) | [[Business Wire]] | | 12/10/2024 | [**ACOs Using Lightbeam Solutions Report Record MSSP Savings in PY23, Driving Cumulative Savings Beyond $3 Billion Milestone**](http://www.businesswire.com/news/home/20241210682108/en/ACOs-Using-Lightbeam-Solutions-Report-Record-MSSP-Savings-in-PY23-Driving-Cumulative-Savings-Beyond-3-Billion-Milestone/?feedref=JjAwJuNHiystnCoBq_hl-RLXHJgazfQJNuOVHefdHP-D8R-QU5o2AvY8bhI9uvWSD8DYIYv4TIC1g1u0AKcacnnViVjtb72bOP4-4nHK5ieT3WxPE8m_kWI77F87CseT) | [[Business Wire]] | | 12/9/2024 | [**Searching for the Policy-Relevant Treatment Effect in Medicare's ACO Evaluations**](https://www.ajmc.com/view/searching-for-the-policy-relevant-treatment-effect-in-medicare-s-aco-evaluations) | [[AJMC]] | | 12/6/2024 | [**Acoramidis Sustains Benefits in Patients With ATTR-CM in Open-Label Extension Study**](https://www.ajmc.com/view/acoramidis-sustains-benefits-in-patients-with-attr-cm-in-open-label-extension-study) | [[AJMC]] | | 11/13/2024 | [**NAACOS pushes ACO REACH extension after $1.54B in savings**](https://www.healthcarefinancenews.com/news/naacos-pushes-aco-reach-extension-after-154b-savings) | [[Healthcare Finance]] | | 11/11/2024 | [**ACO Reach program savings grew larger in 2023. NAACOS is angling for the model's extension**](https://www.fiercehealthcare.com/payers/aco-reach-program-savings-grew-larger-2023-naacos-angling-models-extension) | [[FierceHealthcare]] | | 10/30/2024 | [**Shared Savings ACOs saved $2.1B for Medicare in 2023**](https://www.modernhealthcare.com/insurance/medicare-shared-savings-program-acos-spending-2023ding-2023) | [[Modern Healthcare]] | | 9/16/2024 | [**What Value Do Teaching Hospitals Provide Commercial Beneficiaries When in an ACO?**](https://www.ajmc.com/view/what-value-do-teaching-hospitals-provide-commercial-beneficiaries-when-in-an-aco-) | [[AJMC]] | | 9/4/2024 | [**Do Medicaid ACOs boost patient care access in pregnancy? - TechTarget**](https://www.techtarget.com/patientengagement/news/366609466/Do-Medicaid-ACOs-boost-patient-care-access-in-pregnancy) | techtarget.com | | 8/30/2024 | [**Google working on AI that can detect TB through the sound of cough and breathing**](https://www.msn.com/en-in/health/health-news/google-working-on-ai-that-can-detect-tb-through-the-sound-of-cough-and-breathing/ar-AA1pIx8P) | msn.com | | 8/21/2024 | [**ACO REACH changes more negative than positive, says participant**](https://www.healthcarefinancenews.com/news/aco-reach-changes-more-negative-positive-says-participant) | [[Healthcare Finance]] | | 8/2/2024 | [**NAACOS worries new ACO REACH changes could force exits - Fierce Healthcare**](https://www.fiercehealthcare.com/payers/naacos-worries-new-aco-reach-changes-could-force-exits) | [[FierceHealthcare]] | | 7/23/2024 | [**How ACO models can improve to support patient engagement - TechTarget**](https://www.techtarget.com/patientengagement/news/366596498/How-ACO-models-can-improve-to-support-patient-engagement) | techtarget.com | | 7/9/2024 | [**Unraveling the Financial Ramifications of MSSP ACO Reporting**](https://www.healthitanswers.net/unraveling-the-financial-ramifications-of-mssp-aco-reporting/) | [[Health IT Answers]] | ## Topic Overview (Some LLM-derived content — please confirm with above primary sources) ### Key Players - **National Association of ACOs (NAACOS)**: A key organization representing the interests of ACOs, providing advocacy and support for policy changes affecting accountable care. - **NAACOS**: The National Association of Accountable Care Organizations, which supports ACOs in achieving value-based care. - **Ochsner Accountable Care Network (OACN)**: An ACO that has consistently ranked high in clinical performance and healthcare savings for Medicare beneficiaries. - **CVS Health**: A major healthcare company involved in establishing ACOs to enhance coordinated care for Medicare beneficiaries. - **Centers for Medicare & Medicaid Services (CMS)**: Government agency overseeing Medicare and Medicaid, promoting ACOs as part of value-based care. - **LTC ACO**: Recognized for generating over $130 million in savings since 2018 and selected as a charter collaborator by PALTmed. - **Amino Health**: A healthcare technology company that provides ACO optimization solutions combining physician performance analytics with consulting services. - **The Physician's Accountable Care Organization (TP-ACO)**: An organization partnering with YouScript to implement personalized medication management across multiple states. - **Health Choice Care**: An ACO that discusses the importance of identifying fraudulent billing trends in medical equipment. - **Emily Brower**: New president and CEO of the National Association of ACOs, with extensive experience in clinical integration and physician services. - **Citrus ACO**: Achieved the highest savings rate in the Medicare Shared Savings Program (MSSP). - **VillageMD**: An ACO that achieved significant savings through the ACO REACH model, focusing on high-quality, accessible healthcare. - **CMS**: The Centers for Medicare & Medicaid Services, which oversees the Medicare Shared Savings Program and regulates ACOs. - **Community Care Cooperative (C3)**: Achieved $5.1 million in shared savings during the 2023 performance year of the ACO REACH Model. - **Aisha Pittman**: Senior Vice President of Government Affairs for NAACOS, who has voiced concerns regarding changes to ACO policies. - **Wilmington Health**: An organization that has transitioned to the ACO REACH model, emphasizing data analytics and transparency to improve care quality and achieve significant savings. - **HarmonyCares**: Focused on in-home care for high-need patients, achieving a 23% net savings rate in the ACO REACH model. - **Honest Health**: An organization focused on primary care transformation and accountable care, achieving high-quality scores and savings in the ACO REACH program. ### Partnerships and Collaborations - **CMS and ACOs**: The Centers for Medicare & Medicaid Services (CMS) has implemented new Advanced Investment Payments to support low-revenue ACOs transitioning to performance-based risk initiatives. - **PALTmed and LTC ACO**: Established the Value-Based Care Joint Alliance to assist long-term care providers in engaging with Medicare's value-based care programs. - **Cardio Diagnostics**: Participating in the Florida Association of ACOs conference to showcase AI-powered cardiovascular solutions that align with ACO goals. - **Lightbeam and ACO REACH**: Lightbeam collaborates with ACO REACH organizations to enhance health equity and reduce healthcare costs for underserved populations. - **Innovaccer and Primary Care Collaborative (PCC)**: Released a report highlighting the effectiveness of primary care-centric ACOs. - **Deacon Health and Hospitals/ACOs/Payers**: Collaborating to improve pre- and post-surgical care management. - **Lightbeam Health and ACOs**: Partnerships that resulted in nearly half a billion dollars in gross savings for ACOs in 2023 through effective population health management. - **Milliman MedInsight and ACOs**: Collaboration that enabled ACO clients to achieve $549.3 million in savings in 2023, exceeding national averages. - **Amino Health and Motive Practicing Wisely Solutions**: Launched Amino Motivate, an ACO optimization solution aimed at enhancing decision-making and patient care. - **Buena Vida y Salud ACO and Health Data Analytics Institute**: This collaboration implemented an AI-guided patient targeting approach, leading to significant reductions in emergency department visits and unplanned hospital admissions. - **HF Software Solutions and Beaumont ACO**: Partnership to enhance population health management through data-driven insights. - **CVS and Ohio State University Wexner Medical Center**: Established a new ACO to improve coordinated healthcare delivery for Medicare beneficiaries in central Ohio. - **Amino Health and Motive Practicing Wisely**: These companies have partnered to launch Amino Motivate, an ACO optimization solution that integrates physician performance analytics with consulting services. - **AdvantagePoint Health Alliance**: A clinically integrated network utilizing data-driven resources to enhance value-based care initiatives. - **TP-ACO and YouScript**: Collaborated to implement a personalized medication management program utilizing pharmacogenomic testing. - **Agilon Health and Physician Groups**: Collaborate to create a value-based Total Care Model for senior patients. - **Wilmington Health and AMGA**: Partnered to create the AMGA Value Care Network, aimed at helping medical groups succeed in value-based care models. - **GenieMD and Value Services Management Group**: Partnered to enhance virtual care and chronic care management for the Sunflower ACO network. - **OneCare Vermont**: Collaborates with 14 hospitals and 100 primary care organizations to improve patient care coordination. - **WellSpan Health and Partners**: Collaborative efforts that led to $16.5 million in savings for patients and the Medicare program in 2023, emphasizing care quality and affordability. ### Innovations, Trends, and Initiatives - **ACO REACH Model**: An initiative by CMS to enhance value-based care, focusing on underserved communities and increasing transparency in governance. - **ACO PC Flex Model**: A new model providing per-patient reimbursement for small ACOs to enhance funding and reimbursements. - **AI and Predictive Analytics**: ACOs like LTC ACO are leveraging AI for predictive analytics to enhance clinical outcomes and reduce avoidable hospitalizations. - **ACO REACH**: A pilot program aimed at improving chronic care and health equity outcomes, set to expire at the end of 2026. - **ACO REACH Program**: Designed to promote health equity and accountable care for Medicare beneficiaries in underserved communities, with Honest Health achieving a 97.7% quality score. - **Amino Motivate**: A new ACO optimization solution that utilizes data-driven analytics to enhance physician performance and improve patient care quality. - **Technology in ACOs**: Innovaccer's analytics led to $379 million in savings and a 2% lower readmission rate. - **Next Generation ACO Model**: Allows organizations to choose risk levels and payment mechanisms, distinguishing it from private health insurance programs. - **Value-Based Care Shift**: ACOs are increasingly focusing on value-based care, aiming to reduce healthcare waste and improve patient outcomes through innovative care redesign strategies. - **Data Management Systems**: Implemented by ACOs like Providence to support value-based care initiatives. - **Mandatory Reporting for ACOs**: Starting in Performance Year 2025, ACOs must comply with mandatory reporting of quality metrics, utilizing options like eCQMs, MIPS CQMs, and Medicare CQMs. - **Opportunity Navigator by Innovaccer**: A feature that allows ACOs to benchmark performance and identify expenditure drivers. - **10Bridge's Interoperability Platform**: Enhances data integration across ACOs, improving quality outcomes reporting for approximately 2.5 million patients. - **Digital Quality Measurement Transition**: ACOs are preparing for new reporting requirements under the Quality Payment Program, transitioning to digital quality measures by 2025. - **Advanced Primary Care Management (APCM)**: A proposed model by CMS to enhance health equity by adjusting payments based on patient complexities. ### Challenges and Concerns - **ACO Participation Decline**: Despite record savings, the number of participating ACOs decreased, attributed to factors like increased Medicare Advantage enrollment. - **Impact of ACO REACH Changes**: Concerns that modifications to the ACO REACH model may discourage participation and affect the financial viability of ACOs. - **Provider and ACO Churn**: Challenges in maintaining stable provider participation in ACOs, impacting continuity of care and shared savings. - **Anomalous Billing Trends**: ACOs are tasked with identifying and reporting these trends to protect shared savings, with a focus on combating fraud and waste. - **Quality of Post-Acute Care**: Research indicates that while ACOs improve access to high-quality nursing homes, concerns remain about the quality of care for dementia patients. - **Information Blocking Rule**: NAACOS advocates for changes to prevent penalties that negatively impact ACO participation in Medicare programs. - **Cost Measurement**: Challenges in measuring the actual value of care provided by ACOs, despite generating significant savings. - **Financial Performance Issues**: Several insurers, including Clover Health and Alignment Healthcare, have withdrawn from ACO REACH due to financial challenges. - **Quality Measure Reporting**: Organizations like the American Hospital Association have requested postponements in reporting requirements for ACOs. - **Value-Based Care Models for LTC**: Current ACO models are not adequately designed for long-term care (LTC) and post-acute care (PAC) providers, leading to low participation rates. - **Reporting Burden**: ACOs face challenges in meeting the reporting requirements due to the complexity of data aggregation and validation of patient eligibility. - **Participation Rates**: Less than 10% of skilled nursing facilities are involved in ACOs, indicating a gap in collaboration. - **Social Determinants of Health**: Limited understanding of how ACOs address the social needs of vulnerable patients, with calls for better data collection and action. - **Tax-Exempt Status Issues**: Recent court rulings highlight concerns over tax-exempt status for ACOs with significant commercial activities. - **Beneficiary Leakage**: Concerns about patients receiving care outside of ACO networks, which can undermine cost-saving efforts. - **Participation Disparities**: Less than 2,000 skilled nursing facilities participate in ACOs, indicating missed opportunities. - **Social Determinants of Health (SDOH)**: ACOs are struggling to effectively address SDOH, with many still in early stages of data collection and implementation. - **Documentation Burden**: ACOs face increased documentation requirements, leading to higher after-hours documentation time for physicians. - **Fraudulent Billing Practices**: Concerns over fraudulent billing related to urinary catheters, prompting CMS to propose rules to protect ACOs from financial penalties. - **Provider-Specific Variability**: Variability in vaccination rates among adolescents receiving care from ACOs indicates that individual provider practices significantly impact healthcare outcomes.