The Ochsner Accountable Care Network (OACN) is an Accountable Care Organization (ACO) that consists of over 2,250 providers in Louisiana and Mississippi. OACN was founded to improve health outcomes and support efforts to improve population health across Louisiana and the Gulf South.
For Medicare Fee-for-Service Beneficiaries
An accountable care organization (ACO) is a coordinated group of healthcare providers who have agreed to share responsibility for the care of a defined population of individuals. The Medicare Payment Advisory Commission defines an ACO as: a group of primary care providers, specialists and/or hospitals and other health professionals who coordinate the full continuum of care and are accountable for the overall quality of care and costs for a defined population. (Medicare Payment Advisory Commission). ACO providers coordinate amongst themselves, and with each individual, to improve the individual’s quality of care, the efficacy of the care and to reduce the rate of increasing cost of care over time.
Coordinated care helps ensure that patients, especially those with chronic conditions, get the right care, at the right time, and in the right place. An ACO is not a health insurance plan or a health maintenance organization (HMO). An ACO doesn’t affect Medicare benefits or which providers a patient can choose to see. ACOs put the doctor and patient in charge of patient care, not insurance companies. Being part of an ACO is about better collaboration between providers and a shared commitment to improving the health of the Medicare Fee-for-Service patients they serve.
This is a significant first step in moving away from a fee-for-service reimbursement model to one in which providers are accountable for coordinating the health of a defined population in a way that doesn’t change the program for Medicare beneficiaries or expose providers to financial risk from Medicare. To do well will require a focus on quality, keeping people healthy, and developing an integrated system of care. If successful, this system will lead to improved value in the care we deliver to our Medicare Fee-for-Service beneficiaries.