How does the ACO build on other reform efforts?
The ACO builds on the current CMS Physician Group Practice (PGP) Demonstration, a program in which large group practices are rewarded with a share of the savings they achieve in caring for their Medicare patients if they also achieve documented quality improvement. During the first two years of the program, the participating groups achieved major gains in quality and savings for the Medicare program overall. The ACO is also the overarching structure within which other reforms can thrive, including the medical home, bundled payments, shared decision making, and partial capitation, among others. Providers participating in the ACO can receive medical home payments, bundled payments, etc. However, those payments for patients assigned to the ACO will count toward the ACO’s spending target. The compatibility of the ACO with other payment and delivery system arrangements – and its ability to strengthen other programs – is one of its core strengths. For example, CBO has scored the medical home
