Are you an independent physician considering joining an ACO?

Accountable care organizations (ACOs) are attractive to independent physicians for a number of reasons. ACOs offer independent physicians the benefits of a larger organization while still enabling them to retain their autonomy. The Centers for Medicare & Medicaid Services (CMS) defines ACOs as “groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high-quality care to their Medicare patients.”

The independent physician benefits from an ACO because, in the words of CMS, “when an ACO succeeds both in delivering high-quality care and spending health care dollars more wisely, the ACO will share in the savings it achieves for the Medicare program.” A recent article in Modern Healthcare adds that “As the healthcare landscape grows more complex in the push to value-based care, independent-practice providers … are increasingly looking to ACOs as a way to successfully adapt to payment reform while also keeping their autonomy.”

Physicians like Dr. Pablo Quintela, based in Hollywood, Florida, and who joined the ACO Orange Care Group, say the decision is a relatively easy one. Orange Care Group “provides Quintela with support services to manage his small practice … through one of its four ACOs. It helps him correctly bill claims to the CMS, coordinate care for his Medicare population and prepare for the quality requirements of MACRA through educational sessions and tools.”

Dr. Mary Tilak, based in Indiana, joined Community Healthcare Partners, a Medicare ACO operated by three-hospital Community Healthcare System, and enjoys the ACO’s ability to invest in health information technology as a larger organization. Tilak says, “Without health information technology, you can’t do this kind of collaborative care and move up in value-based purchasing, so it becomes critical to make these investments. That is where these large organizations can come in to help,”

Orange Care Group also invested heavily in health information technology to benefit its 450 independent physicians who may need to coordinate care for their patients. Many of its members use different electronic health record (EHR) systems and the ACO’s ability to invest in IT enables those separate systems to “easily understand and compare patient outcomes data.” Orange Care Group has also partnered with hospitals on data sharing “so doctors are notified if their patients are admitted to the emergency room and require follow-up care.”