Inter Organizational Practice Committee

Health Care Reform and Neuropsychology Toolkit

The IOPC is a super committee of AACN, NAN, D40, and ABN, tasked with coordinating advocacy efforts and improving the practice climate for Neuropsychology. The Healthcare Reform Toolkit is an evolving interactive website designed to educate neuropsychologists about healthcare reform and share effective practice models

First we need to get some terminology straight. What is an ACO?

An Accountable Care Organization (ACO) is a group of providers where reimbursement for an assigned population of patients is tied to:

        1. quality markers and

        2. reduction of total cost of care

In other words, there is a set group of patients, say 10,000 in a particular town, and they are assigned to a a group of doctors and providers: the ACO.   The ACO providers will try to keep the overall cost of care for the entire population down.  At the same time, they need to meet quality measures, like providing screenings for cancer, and achieving good blood pressure and other markers of health for their patients. An ACO might consist of multiple "medical homes" or multiple primary care practices and specialty practices.  A hospital is often part of the ACO organization. 

Neuropsychologists may or may not have official membership in an ACO.  For example, a community based neuropsychologist in private practice might have a referral relationship with an ACO, but not be an official member.  In a university hospital system, all employees, including neuropsychologists, may automatically be enrolled in the hospital based ACO.  

For a great reference guide and primer on ACOs, we recommend the ACO Toolkit written by the Brookings Institution and the Dartmouth Institute for Health Policy.

How do I find the ACO's in my community?

In most states, ACOs will be forming in the next several months.  Many existing physician organizations, like PHO's (Physician Hospital Organizations) will decide to form ACOs.  Hospital systems will likely form ACO's within their existing network.  Neuropsychologists who are not employees of large healthcare systems should contact major physician referral sources and ask them, "Do you belong to an ACO?" Most neuropsychologists will want to affiliate with ACOs to which their major referral sources belong.

Membership in ACOs

Find the ACOs in your community by calling your top referral sources and asking them what ACO they are joining