Accountable Care Organizations (ACO)

According to Centers for Medicare and Medicaid Services, Accountable Care Organizations (ACOs) are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to the Medicare patients they serve.

Examples of Accountable Care Organization (ACO) or Shared Savings Investment Activities

ACO or Shared Savings Investment Activities Allowable Activities
A. Computerized provider order entry implementation and/or training

Any educational trainings that support provide use and implementation.

B. Pharmacy services training, hardware/software, and machines

Does NOT include pharmacists' services or medication.

C. Population health or disease registry training and/or software/hardware*

Educational training, or hardware/software to support the development and implementation of a disease registry for care coordination.

Software and training for analysis of population health needs by chronic disease or geographic location for care management programs.

D. Social determinants of health (SDOH) screening software/training

Software and training for analysis of social determinants of health* for improving health outcomes and care management programs.

E. Efficiency or quality improvement training/or software in support of ACO or shared savings related initiatives*

Quality Improvement training such as the following:

Consider other efficiency or quality improvement training to address performance issues related to the following:

F. Systems performance training in support of ACO or shared savings related initiatives  

Hospitals interested in systems performance training should consider adopting a framework approach in transitioning to value-based system planning such as one of the following:

    G. Telehealth and mobile health hardware/software

Training hardware/software that supports the application and implementation of telehealth and/or telemedicine. This does NOT include telecommunications. Tablets and hardware/software investments are allowed if they are used by staff to improve operational efficiencies and telehealth services.

H. Community paramedicine hardware/software and training

Community Paramedic Program (CPP) training. If the hospital and/or hospital-owned ambulance unit has a formal CPP, then hardware/software can be purchased to support the CPP to reduce emergency medical services (EMS) and emergency department misuse and readmissions. However, use of SHIP funding for general EMS equipment is not allowable.

I. Health Information Technology (HIT) training for value and ACOs

SHIP supports HIT hardware/software and training, therefore, it would be beneficial to include risk assessments and/or trainings associated with cybersecurity.

* New or expanded activities and examples

Provided below is a bar graph of the number of hospitals between FY2016 - FY2018 that invested in ACO specific investment activities.

Resource List

This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UB1RH24206, Information Services to Rural Hospital Flexibility Program Grantees, $1,560,000 (0% financed with nongovernmental sources). This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.