It's getting confusing. What's a Pioneer ACO vs. a CMS ACO? How is the savings shared or how are penalties determined? How many medicare patients does an organization need to be able to care for to participate? These questions and others are frequently asked in the circles I am in. I decided to define some of these questions and the answers at least as we know them right now.
First, the CMS website is a pretty good start to understand what an ACO is or at least what CMS thinks it is. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ACO/index.html?redirect=/ACO/ This also has links to the Medicare Innovation payment programs including bundled payment, comprehensive primary care payment, and community based transition programs.
Next I am enclosing a document that describes the difference, again as we know it today, between the Pioneer ACO model and CMS ACO model. This document helps to answer some of the questions above and others. ThedaCare - Pioneer and Shared Savings ACO Side-bySide_103083595(1)
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