Value-based care is growing: How to choose the right ACO partner

The Centers for Medicare & Medicaid Services (CMS) has made its vision clear: the shift toward alternative payment models that reward quality over quantity is a permanent evolution in health care. While value-based care offers a path toward better patient outcomes and financial sustainability, the administrative and financial risks can be daunting to manage alone. Joining an accountable care organization (ACO) is often the most viable solution.

ACOs are groups of clinicians that work together to improve care quality at lower costs through coordinated, prevention-focused care.

There are different types of ACOs tailored to specific populations and health plans. Organizations may participate in the Medicare Shared Savings Program (MSSP), commercial contracts or specialized models. Despite these variations, the goal remains the same: delivering better care at lower costs.

While joining an ACO is a proven path forward, choosing the wrong partner can cost you your autonomy. Selecting the right partner requires a thorough evaluation to ensure a sustainable and aligned partnership.

Consider these four critical factors when choosing an ACO partner:

1. Physician-led philosophy and autonomy

For independent practices, the greatest fear is losing clinical or operational control. The right ACO partner should empower your independence, not dilute it. Look for an ACO that is physician-led and understands the specific needs of your practice. Ask how much “say” your practice will have in governance and whether the ACO’s clinical protocols allow for the flexibility required to treat your unique patient population.

2. Proven financial transparency and distribution models

Financial incentives aligned with quality outcomes are the engine of value-based care. It is essential to understand the ACO’s track record of generating shared savings and, more importantly, how those savings are distributed.

• Transparency: Does the ACO provide clear, regular reporting on financial performance?
• The split: What percentage of shared savings goes back to the practice versus being spent on the ACO’s overhead?

3. Actionable data and technology support

In a value-based world, data is your most valuable asset. A top-tier ACO should provide more than just a software portal; it should provide holistic patient insights sourced from across the care continuum. Ensure the partner offers robust population health management tools that integrate with electronic health records.

4. Practice support resources

Moving to value-based care requires a shift in workflow. The ideal ACO partner provides value-based care experts, coaching and on-demand learning tools — all informing clinical and administrative work. These resources should help you optimize Medicare annual wellness visits, reduce acute events and manage chronic conditions seamlessly.

Choosing an ACO is one of the most significant business decisions an independent practice owner will make. By focusing on cultural alignment, financial transparency and robust technical support, you can ensure that the transition to value-based care protects your practice’s legacy and improves your patients’ lives.

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