Bluestone Accountable Care Organization (ACO)

Bluestone Physician Services is participating in an Accountable Care Organization called Bluestone ACO. An ACO is a group of health care providers that work together to improve the quality and experience of care for people who have Original Medicare. ACOs are designed to put patients at the center of their care and help them navigate a complex health system.

When an ACO succeeds in both delivering high-quality care and spending healthcare dollars more wisely, it’s eligible to share the savings it achieves for Medicare. ACOs can use the payment to invest more in your care or share a portion with your providers. ACOs may owe a penalty if their care increases costs.

Bluestone ACO was the #1 performing ACO in the Medicare Shared Savings Program in 2022 and 2023, as measured by savings per beneficiary, and ranked in the top 10% with exemplary quality scores.

Bluestone ACO patients get extra help with an assigned Complex Care Manager who proactively focuses on delivering the right care at the right time, while avoiding unnecessary services. In partnership with Bluestone Primary Care Providers, Complex Care Managers:

• Coordinate between different members of a patient’s care team including assisted living or group home community staff and family.
• Use data and analytics to monitor health status and recommend interventions to avoid hospital stays.
• Liaise with emergency department, hospital staff and Bluestone primary care provider to assist with information exchange to ensure care is appropriate and aligned to patients’ wishes.
• Facilitate skilled nursing facility 3-day waiver or recommend post-acute setting options including SNF affiliates.
• Support transitions to maintain safety and thrive at home.

For more information about ACOs, refer to these resources from the Centers for Medicare and Medicaid Services (CMS):

• Accountable Care Organizations — explained
• Medicare Shared Savings Program
• Medicare.gov | (800) MEDICARE (800-633-4227)
  24 hours a day/7 days a week. TTY users should call (877) 486-2048