Learning Systems for Accountable Care Organizations

Prepared for
U.S. Department of Health and Human Services, Center for Medicare & Medicaid Innovation
stethoscope with computer in background

Accountable Care Organizations (ACOs) are comprised of doctors, hospitals, and other health care providers working together to provide coordinated, high quality care to Medicare patients. They accept responsibility for cost and quality of care for their patients and provide data to be used to assess performance. The goal is to ensure that patients, especially the chronically ill, get the right care at the right time, while avoiding duplication of services and preventing medical errors. ACOs that deliver quality care efficiently share in the Medicare savings produced.

Four types of Medicare ACOs are being served by two learning system projects: (1) Pioneer, (2) Shared Savings Program, (3) a type of ACO that focuses on patients with end-stage renal disease, and (4) the Next Generation model, which launches on January 1, 2016. To help these Medicare ACOs learn from each other, these projects involve working with the Center for Medicare and Medicaid Innovation to create a structure for training and peer-to-peer learning. Models and payment approaches must be adaptable to fit local communities and markets, and the system must be flexible enough so that all parties can learn from ongoing experience. The learning system promotes rapid diffusion of successful models and achievements across the country.

Mathematica and our partners—HCMDM, HSAG, Institute for Healthcare Improvement, Premier Inc., and Telligen—developed and are implementing a curriculum delivered through innovative channels such as webinars, action groups, learning collaboratives, regional and national in-person meetings, distribution of tools and resources, and a dashboard to measure and benchmark the ACOs' performance. The dashboard enables individual ACOs to see their performance results and benchmark against their peers. CMS can also use the dashboard to view progress across the program.

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