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Accountable Care Organizations

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.”

Related Resources

Final ACO Rules Adopt ANA’s Recommendations on Nursing Leadership, Patient-Centered Care (10/25/11)

ACOs 101 - The Basics of Accountable Care Organizations
A primer on the concept of an Accountable Care Organization - a shared savings program for Medicare to improve quality and reduce cost.

Follow the Money - Financial Impact of Accountable Care Organizations
The financial risks and benefits to healthcare providers practicing as an Accountable Care Organization

ANA Comments to CMS on Accountable Care Organizations Proposed Rule
ANA recommended significant changes to the proposed Accountable Care Organization (ACO) rule. ANA's comments seek to maximize patient care and create greater efficiencies and savings by articulating professional nursing's impact on areas of leadership, patient-centered care coordination, and quality.

ANA Comments to FTC/DOJ on Accountable Care Organizations Rule
The Federal Trade Commission and the Antitrust Division of the Department of Justice propose modifications of the antitrust laws to permit otherwise independent healthcare organizations to collaborate as Accountable Care Organizations. ANA submitted comments to make sure that RNs are included in leadership roles in ACOs, RN services are included in calculating the ACO patient “pool,” and paperwork burdens do not divert healthcare professionals from providing direct care.

Care Delivery Models in Health Care Reform: Opportunities for Nurses
PPACA directs renewed attention and substantially more resources and incentives to promote those elements of care which are also the backbone of nursing practice. These essentials include patient-centered care; care continuity; coordination and integration across settings and providers; chronic disease management; patient education; prevention and wellness care; and information management.

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.

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