Contracts with Accountable Care Organizations

 

Sansweet, Dearden and Burke, Ltd. (SDB) reviews and negotiates physician contracts with Accountable Care Organizations (ACOs). ACOs are networks of health care providers that share financial incentives to reduce health care costs for beneficiaries while meeting certain health care standards.

 

Accountable Care Organizations

In recent years, ACOs have become increasingly prevalent as policymakers seek to promote coordinated care and cost efficiency. Medicare offers several ACO options, including the Medicare Shared Savings Program. In addition, many private insurers are encouraging similar arrangements, known as commercial ACOs.

 

Financial and Medical Implications

Physicians who are considering participation with an ACO should consider the financial and medical implications, including:

  • What investment is required?
  • What is the composition of the ACO’s provider network?
  • Who makes the medical decisions?
  • How are the doctors paid?
  • How and when may the ACO contract be terminated?
  • What does the physician lose by not participating?