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Physician-Led Accountable Care Organizations (ACO’s)

What Are Accountable Care Organizations (ACOs)?

The Affordable Care Act established Accountable Care Organizations (ACOs) to integrate care delivery across multiple health care providers.  ACOs are collaborations between physicians, hospitals and health professionals that are clinically and financially accountable for the delivery of health care.  The philosophy is based on a patient-centered approach of care that emphasizes primary care and prevention.  Each ACO strives to achieve the three part goal of Center for Medicare and Medicaid Services (CMS):  better population health, better individual outcomes, and lower costs.  In return for the increased accountability, Medicare will share a portion of the savings generated with the ACO and its participating providers.

MedChi Network Services (MNS) ACO model focuses on the delivery of high quality and cost-effective health care to its Medicare members.  MNS was awarded 3 Advance Payment ACOs by CMS:  Maryland Accountable Care Organization of Western MD and Maryland Accountable Care Organization of Eastern Shore were approved and began on July 1, 2012 and Lower Shore ACO began on January 1, 2013.

MNS is participating in the Medicare Shared Savings Program to provide advances in interdisciplinary care and coordination of patient care.  A robust health IT infrastructure is implemented to allow real-time processing of health information.  All our ACO physicians comply with and implement its quality assurance and improvement program including:

  • Promoting evidence-based medicine
  • Promoting beneficiary engagement
  • Promoting coordination of care
  • Internal reporting on cost and quality
  • Typical of an ACO, the foundation of MedChi’s ACOs is patient choice, so our patients are not limited in physician & treatment options like an MCO. At any time, our members can choose to leave an ACO.

The direction of health care is changing, and physicians and their patients must be at the forefront. Better teamwork, better communication, better treatment, and better value means Marylanders will receive the high quality of care they deserve.

MedChi ACOs in Maryland

On July 1, 2012, CMS approved four ACOs in the state of Maryland. Two of the ACOs are comprised solely of independent primary care physicians: Maryland ACO of the Eastern Shore and ACO of Western Maryland. Both of these ACOs applied for the competitive Advance Payment option, which provides a non-recourse loan to support the development of the ACOs. MedChi Network Services is managing those ACOs.

Another round of ACO approvals occurred on January 1, 2013 and a third physician-only ACO was awarded the Advance Payment option. The Lower Shore ACO is the largest of the three Advance Payment ACOs and is also managed by MedChi Network Services. An affiliate vendor of MedChi formed multiple County-based ACOs as well.

Getting Started

MedChi Network Services is coordinating care for approximately 25,000 Medicare beneficiaries through the Advance Payment ACOs. MedChi supports the continued formation and development of physician-led ACOs. There are groups around the state in various stages of implementation, and MedChi will help physicians and ACOs work together to enhance care.

For more information, please email info@medchiservices.org or call 1-888-507-6024.