Accountable Care Organizations (ACOs) are legal entities which are designed to allow integrated networks of providers that improve patient outcomes and lower costs to share in the savings that come from more integrated and coordinated care. With the passage of the Affordable Care Act, the Center for Medicare and Medicaid Innovation (CMMI) has become a leading force in efforts to encourage ACOs and other delivery system reforms.
The Medicare Shared Savings Program is the most well known of these efforts but CMMI also has launched smaller initiatives, such as the Pioneer ACO Model and Advanced Payment Initiative. All of these programs are modeled on Medicare's Physician Group Practice (PGP) Demonstration Project, which demonstrated cost savings from greater integration while preserving fee-for-service payments.
IDSA is generally supportive of the ACO concept but believes that their development must coincide with a full range of waivers, safe harbors, and exceptions to federal anti-trust laws as a means encourage greater integration. The Society also strongly supports shared savings payments for infection prevention, antimicrobial stewardship, and other systems-level activities that are focused on avoiding healthcare-related
complications and their associated costs.
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