ACOs: Medicare and MassHealth

By participating in an ACO, your primary care physician can enhance the care you receive by coordinating with your other health care providers. Together, they share your health information to better meet your individual needs and care preferences.

The goal of an ACO is for doctors, hospitals, and other health care providers to work closely together to deliver coordinated, high-quality care.

ACOs have agreements with insurance companies to provide special services and care coordination for patients. These agreements set performance standards in quality and spending for the ACO. If the ACO is able to meet or exceed these standards for patient care, they may be eligible for shared savings with the insurance company. If they do not meet the standards, they may have to pay money back to the insurance company.

Since 2012, our health system entered into contracts with all the major insurers, including the Centers for Medicare and Medicaid Services (CMS), commercial payers, and MassHealth (state Medicaid program).

After five years in the Medicare Pioneer ACO model, we saved $36.7 million. As a Medicare Next Generation ACO, with an overall quality score of 100% in 2017, we were among the top ACOs in the nation for delivering high-quality care to patients. Today, we participate in the Mass General Brigham Medicare ACO (Medicare Shared Savings Program), as well as the Mass General Brigham MassHealth ACO.

We are committed to improving the health of individual patients and patient populations, while lowering costs.

Many of our affiliated providers are participating in a care coordination program called the Medicare Shared Savings Program (MSSP), designed specifically for Medicare patients and sponsored by Medicare. 

As part of the Mass General Brigham Medicare ACO, your provider may be participating in this program, including providers affiliated with Brigham and Women's Hospital, Massachusetts General Hospital (including Nantucket Cottage Hospital and Martha’s Vineyard Hospital), Newton-Wellesley Hospital, Salem Hospital, Cooley Dickinson Hospital, Emerson Hospital, Pentucket Medical Associates, Milford Regional Physicians Group, Wentworth-Douglass Hospital, and Charles River Medical Associates.