Out-of-Network Primary Care Linked to Higher ACO Costs

RevCycle Intelligence February 19, 2020
Emily Sokol, MPH

Primary care services outside of accountable care organizations’ networks are associated with increased costs, according to a new study.

Patients receiving primary care outside of their defined accountable care organization (ACO) network drive up costs for ACOs, a recent study from Portland State University said.

The Medicare Shared Savings program sparked the growth of ACOs. These payment models intend to reduce healthcare costs while improving patient care through care coordination among a network of participating providers.

Those involved in the model work to keep patients in the network of providers, usually emphasizing primary care services. ACOs want to reduce healthcare costs by eliminating unnecessary emergency department utilization and by caring for problems in primary care when appropriate rather than pointing...

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