How Does an ACO Differ from the Patient-Centered Medical Home?

There are few things that healthcare regulators like more than a good acronym. With alphabet soup like PCMH, ACO, MSSP, VBR, and FFS, it can sometimes be difficult to tell what the real differences are between the various quality and value-based reform options available to providers.

After understanding what the patient-centered medical home is and how it’s structured, the next question to ask is how the PCMH model stacks up against another familiar initiative: the accountable care organization (ACO). [practicetransform]

In this installment of’spractice transformation series, we will break down the differences between the patient-centered medical home and the accountable care organization to help healthcare providers choose a strategy for performance improvement, population health management, and quality patient care.

Different paths, different purposes

Both the patient-centered medical home and the ACO models are intended to help healthcare providers move away from volume-based, fee-for-service reimbursement and towards a more individualized, managed patient ecosystem, but each achieves this in a slightly different way.

The PCMH requires providers to expand access, improve chronic disease management, and focus on the specific needs of patients and their caregivers in order to achieve an official recognition.  While PCMHs must demonstrate their commitment to continuous improvement in order to achieve recertification, But unlike in an ACO, PCMH providers are primarily accountable to themselves when investing in the development of personalized care in ways that often go above and beyond the basic requirements for recognition.

PCMH providers may certainly participate in additional value-based reimbursement programs or accountable care agreements with their payers, but there is no financial reform component required.

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