Accountable Care Organizations

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ANA worked hard to ensure that nurses, including APRNs, were recognized in and incorporated into the Affordable Care Act (the health reform law of 2010). Now that the law has been signed,  the regulatory work to implement it is underway. One area of particular importance to ANA regards accountable care organizations or “ACOs.”

An ACO refers to a group of providers and suppliers of services (for example, hospitals, nurses, physicians, and others involved in patient care) that will work together to coordinate care for the Medicare beneficiaries they serve. To be eligible, the ACO must serve at least 5,000 Medicare patients and agree to participate in the program for three years.

The goal of an ACO is to deliver seamless, high quality, patient-centered care for Medicare beneficiaries instead of the fragmented care that has so often been part of fee-for-service health care. The Affordable Care Act specifies the groups of providers and suppliers that can form an ACO. That list includes “ACO professionals,” who are defined as physicians, nurse practitioners (NPs), clinical nurse specialists (CNSs), and physician assistants. (It is unfortunate that certified nurse-midwives were not included in this list.) Networks of individual practices of ACO professionals, partnerships, or joint venture arrangements between hospitals and ACO professionals, and hospitals employing ACO professionals can also form ACOs.

Read more on ACOs, and ANA comments to the proposed rule on how ACOs would operate.