An Accountable Care Organization (ACO) is a system of managed care encompassing a set of health care providers associated with a defined population for whom they are going to be providing coordinated medical care. Medicare has a shared savings program that promotes the development and use of ACOs to:
- reduce costs
- encourage good quality care and
- improve outcomes
The goal of ACOs is to reduce fragmentation of care and provide incentives that pay for quality, rather than quantity, of care. The intention is to pay for patient centered outcomes instead of provider-based outcomes, promote communication among health care providers to enhance quality and to encourage best practices for each episode of care, regardless of which practitioner within the organization is providing the service.
Under the current system, Medicare limits opportunities for reimbursable telemental health services. However, the focus on quality measures, benchmarks and outcomes makes telecare a logical choice as a component of ACOs as they continue to expand as a model of service delivery. Currently, Medicaid has little involvement with ACOs but there are many innovative proposals in the private and public sectors worth watching.