The accountable care organization (ACO) and other outcomes-based reform models require a high degree of financial and clinical integration. ACOs are designed to encourage providers to think of themselves as a group with a defined patient population, care delivery goals, and performance metrics. Many hospitals and health systems have identified becoming an ACO as a significant part of their future vision and strategic direction. Becoming an ACO will require organizations to shift their focus from care delivery to care management, and will entail taking on greater financial risk.

Despite a lack of clarity regarding the ACO pilot program for Medicare, current legislative details suggest ACOs will need to meet the following criteria:
Agreement to become accountable for the overall care for a designated set of Medicare beneficiaries.
Agreement to a minimum 3-year participation period.
Establish formal management and legal structures that would allow the ACO to provide health services efficiently across the continuum of care.
Include PCPs, specialists, and others to be determined by the Secretary of Health and Human Services (HHS).
Define processes to promote evidence-based medicine, report on quality and cost measures, and coordinate care.
Demonstrate that it meets patient-centered criteria as determined by the HHS.
These standards require a degree of integration that few healthcare delivery systems currently achieve. The session will address the core competencies, critical success factors, and key questions which organizations must address in order to chart their course to achieving their ACO vision. The presenter will also discuss the details of an ACO readiness action plan that includes a review of the financial, operational, and strategic requirements for the creation of an ACO.