Are ACOs providers or insurers? Sometimes both.

Yesterday CMS announced 27 new “shared savings” ACOs. A tip of the hat to Charles Roades, Chief Research Officer of The Advisory Board Company, who tweeted that among them are nine provider groups (IPAs) that are affiliated with Collaborative Health Systems. Collaborative Health Systems is a subsidiary of Universal American Corporation, which offers insurance products, including Medicare Advantage plans.

So, are ACOs providers or insurers? Usually they’re thought of (and are) provider groups. By definition they can’t be insurers only. However, in some cases, they’re both. To what extent does integration with an insurer matter? Time will tell.


Related, CMS also announced five participating organizations in its “advanced payments” flavor of ACO programs. There’s one more flavor, Pioneer ACOs, of which there are 32. Not yet announced are the “zesty ranch” and “chipotle” flavors (h/t Jeffrey Young).


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