One acronym that's totally transforming health care

By Regence BlueCross BlueShield of Utah

January 21st, 2015 @ 10:00am

The health care industry is rife with acronyms: ICU, RN, MD, HMO and PPO just to name a few. Now, yet another three-letter combination is rising in popularity within the industry's vernacular: ACO.

ACO stands for Accountable Care Organization, first introduced during the development of the Affordable Care Act, which is also commonly known as the ACA.

A provider group organizes an ACO to work on increasing the quality of care patients receive while also lowering costs. These provider groups partner with third-party payers to get access to detailed cost data that identifies inefficiencies, redundancies and gaps in care.

The Centers for Medicare and Medicaid Services, commonly referred to as CMS, pioneered ACOs with passage of the ACA.

Regence BlueCross BlueShield of Utah took the ACO concept outside of Medicare and launched a separate model called Total Cost of Care for physician groups of all specialties, but largely addressing primary care.

Although the concept is still new to many physicians, the rollout of the Total Cost of Care program has been well received. Several of Utah's larger provider groups have embraced it, serving as pilot groups, and have reported great results.

Two notable examples are University of Utah Medical Group and Central Utah Clinic, with nearly 1,400 providers between them.

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One acronym that's totally transforming health care