What is an Accountable Care Organization?
An Accountable Care Organization, or ACO, is a group of hospitals, independent providers and other health care organizations who work together to improve quality of care for Medicare beneficiaries and curb the rising cost of health care.
Our region’s ACO is called the HealthCare Partners of the North Country.
Our ACO partners – who are listed on this page – have agreed to be accountable for the overall health and costs of their patients. As a group, if we successfully reduce cost and improve the quality of care for the Medicare beneficiaries we treat, the Centers for Medicare and Medicaid Services (CMS) will reward us in “shared savings.”
To achieve these goals, the HealthCare Partners of the North Country is preparing its partners to thrive in a value-based payment system. Unlike our current health care system, which reimburses providers on a fee-for-service basis, the value-based payment model rewards hospitals and providers for keeping their patients healthy and costs low.
Specifically, our ACO is focused on preventative health initiatives and other wholistic solutions that help patients with chronic diseases manage their conditions and symptoms. Our 2019 key initiatives include: patient engagement, Chronic Care Management and Transitional Care Management, hospice and palliative care utilization, increased influenza and pneumonia vaccination rates, increased collaboration with skilled nursing facilities, annual wellness visits, and improving Hierarchical Condition Category coding accuracy. We also provide transparent data to our partners using sophisticated data processes.
HealthCare Partners of the North Country is committed to improving the quality of care for Medicare beneficiaries, both clinically and socially.
Resources for ACO Partners
- ACO 2018 Web Interface Quality Measures
- 2018 CMS Web Interface Measures List
- 2018 CMS Web Interface Measure Coding: Release Notes
- CARE-1: Medication Reconciliation Post-Discharge
- CARE-2: Falls – Screening for Future Fall Risk
- DM-2: Diabetes Hemoglobin A1c (HbA1c) Poor Control & DM-7: Diabetes Eye Exam
- HTN-2: Controlling High Blood Pressure
- IVD-2: Ischemic Vascular Disease (IVD) – Use of Aspirin or Another Antiplatelet
- MH-1: Depression Remission at Twelve Months
- PREV-5: Breast Cancer Screening
- PREV-6: Colorectal Cancer Screening
- PREV-7: Preventive Care and Screening – Influenza Immunization
- PREV-8: Pneumococcal Vaccination Status for Older Adults
- PREV-9: Preventive Care and Screening – Body Mass Index (BMI) Screening and Follow-up Plan
- PREV-10: Preventive Care and Screening – Tobacco Use: Screening and Cessation Intervention
- PREV-12: Preventive Care and Screening – Screening for Depression and Follow-up Plan
- PREV-13: Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
- ACO 2018 Quality Measure Narratives
- ICD-10: HCC Coding Reference for Family Medicine
- Top ICD-10CM To HCC Codes for Primary Care
- Medicare Shared Savings Program: Shared Savings and Losses and Assignment Methodology
- Department of Health and Human Services: Transitional Care Management Services
Quick Guide for Patients:
- An ACO is a group of doctors, hospitals, and/or other health care providers that work together to improve the quality and experience of care you receive. They do this using a number of strategies, often including increased coordination of care, which can help make sure patients get the right level and quality of care, at the right time, and at the right setting.
- Several hospitals, independent providers, and other health care organizations in our region participate in the Healthcare Partners of the North Country ACO.
- ACOs may receive a portion of savings that result from reducing costs and meeting quality requirements.
- An ACO is not a Medicare Advantage plan, an HMO plan, or an insurance plan of any kind.
- For more information, check out CMS’ info sheet on ACOs by clicking here.
