Provider Resources

ACO information to support collaboration with providers and clinical staff

Helpful Documents

CMS Provider Fact Sheet

CMS Quality Fact Sheet

CMS Rural Healthcare Fact Sheet

Common Questions

What is the cost to participate?

There is no cost to participate. Many ACO participants elect to add care coordination and/or population health resources to assist in high-risk patient engagement and other population health initiatives, while other practices are able to integrate these functions using existing resources.

What is required of an ACO participant?

ACO participants are required to meet a set of annual metrics in order to maintain eligibility for a shared savings payment if shared savings are earned. These metrics include participation in monthly/quarterly partner meetings, annual quality reporting which covers the standard MIPS requirements, engagement with the local team to review your practice’s data and progress, and a sustaining a dedicated focus to advancing high-quality preventive care in your community.

How will ACO participation impact my practice’s fee-for-service revenue?

When operating successfully, an ACO will promote an enhancement of primary care services, especially for complex and high-risk patients. These enhanced services include annual wellness visits, transitional care coordination visits, chronic care coordination and advanced care directives, each of which is reimbursable, resulting in a increase in fee-for-service revenue for participating practices.

How are ACO patients assigned?

CMS assigns patients to the ACO based on the plurality of primary care services provided over the last three years. Generally speaking, your practice will be assigned the patients for whom your practice has provided the majority of primary care services.

What ACO support services can providers access?

ACO Participants to have access to the following resources:

  • Physician led operational leadership and management
  • Engaged acute care-based case management and transitional care team
  • Centralized care coordination team
  • A high performing post-acute care network
  • Provider practice support team focused on population health
  • Real-time notifications for acute care patient activity
  • Practice-facing analytics platform
  • GPRO reporting guidance, assistance and support
Where can I find more information about ACOs?

Call 1-800-MEDICARE (1-800-633-4227) 24 hours a day / 7 days a week
TTY users should call 1-877-486-2048