Accountable Care Organization (Medicare)

Our History & Goals as a Medicare ACO

Effective January 2014, Physician Health Partners (PHP), along with our strategic partner Independent Practice Associations (IPAs), became 1 of 123 new Accountable Care Organization (ACO) participants in the Medicare Shared Savings Program established by the Centers for Medicare & Medicaid Services (CMS). These IPAs are comprised of a network of individual practices of ACO professionals and combined provide care for more than 24,964 Medicare fee-for-service beneficiaries in the Denver metro area.

In January 2012, PHP and our affiliated primary care physicians began as an ACO through the CMS Innovation Center Pioneer ACO model. PHP was chosen specifically by CMS as the only organization in Colorado, and 1 of 32 leading-edge health care organizations around the country, to test the effectiveness of several payment models to help health care providers make a rapid transition to higher quality care at a lower cost to Medicare. The Shared Savings Program is a different Medicare ACO program that bears less financial risk for the ACO, while still offering more services to patients.

The goals remain the same – to improve the patient care experience and outcomes while lowering associated costs.

With the Shared Savings Program, CMS evaluates ACOs on 33 quality performance measures in the areas of patient and caregiver experience of care, care coordination and patient safety, appropriate use of preventive health services, and improved care for at-risk populations. PHP and our participating providers collaborate with hospital systems, like-minded specialists and community resources to achieve these goals. Medicare shares any savings achieved through improving care coordination and providing appropriate, safe and timely care. 

We have a long record of accomplishment with effectively coordinating the quality and cost of care for Medicare patients, and we are hopeful we can continue to make great strides toward improved outcomes through participation in the Shared Savings Program.