A Primer on CMS-Regulated Accountable Care Organizations

Rita Isnar | July 2014

The Centers for Medicare & Medicaid Services (CMS) defines an Accountable Care Organization (ACO) as a group of doctors, hospitals, and other healthcare providers, who voluntarily and jointly coordinate high-quality care to their Medicare patients.  For the purpose of this article, these are defined as CMS-regulated ACOs.

The goal is to ensure that all patients receive the most cost effective and results-based care on a timely basis. This is especially true for chronically ill or sicker patients; CMS has expressed that the intended objective is to avoid unnecessary duplication of services and to prevent medical errors for these patients.

About the Author

Rita Isnar joined Strategic Management in 2003 and is responsible for client fulfillment activities. Her in-depth knowledge and compliance experience includes managed care, Medicare Parts C & D compliance program development and implementation, government enforcement initiatives, quality of care issues and regulatory compliance.