What is an ACO?

Accountable care organizations (ACOs) are groups of doctors, hospitals and other health care providers who come together to provide coordinated care to their patients.

The goal of coordinated care is to ensure that patients, especially the chronically ill, get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors.

Contacting Medicare

For general questions or additional information about Accountable Care Organizations, please visit www.cms.gov and do a search using that term, or call 1-800 MEDICARE (1-800-633-4227).

TTY users should call 1-877-486-2048

Legal & Regulatory

Participation Waiver

OSF Healthcare System (“ACO”) participates in Medicare Shared Savings Program (“MSSP”) Enhanced, which qualifies as an Advanced Alternative Payment Model (“Advanced APM”) under the Quality Payment Program established by the Medicare Access and CHIP Reauthorization Act (MACRA).

As a result, providers / suppliers participating in the ACO may qualify as Qualifying Advanced APM Participants which makes them eligible to receive incentive payments, although the incentive payments will be paid to ACO’s affiliated participants (“ACO Participants”) to whom the providers / suppliers have reassigned their billing rights. 

Pursuant to an arrangement approved by ACO’s Governing Body on March 7, 2019, ACO will pay certain physician independent contractors who qualify as Advanced APM Participants an incentive payment, if applicable, as described in the participating clinician agreement.

ACO Public Report (PDF)

Results

An ACO is required by Medicare to report several quality metrics. The metrics are divided into these four categories:

1. Patient and Caregiver Experience
2. Care Coordination and Patient Safety
3. Clinical Care for At-Risk Population
4. Preventative Health

Below is a high level summary of OSF HealthCare quality scores since participating as an ACO in 2012.