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As health systems seek growth opportunities in the employer market, participating in accountable care organizations (ACO), which originally sprang up within Medicare, is a potentially valuable approach. With larger employers increasingly exploring direct contracts with health systems including ACOs, a body of experience can be drawn upon from Medicare ACOs.
There are currently 561 ACOs with 10.5 million assigned beneficiaries participating in the Medicare Shared Savings Plan (MSSP) (CMS, 2018). Many organizations began participating in a commercial ACO with traditional up-side risk models, bundled payments, or medical homes. A few challenges to be aware of include meeting national quality score averages, working within limited networks, access to multiple data sources, and failing to consider important fiscal targets.