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ACOs: Medicare and MassHealth

As an Accountable Care Organization (ACO), our affiliated doctors, hospitals, and other health care providers come together to provide coordinated, high-quality care to our patients.

ACO certification seal from Health Policy Commission for 2024-2025

About ACOs

Improving your care

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.

What does “accountable” mean?

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.

Our commitment to high-quality care

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.

Mass General Brigham Medicare ACO (Medicare Shared Savings Program)

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.

Your Medicare Benefits

Have questions?

For questions on Medicare benefits, please call Medicare at 1-800-MEDICARE (1-800-633-4227).  
(TTY users should call 1-877-486-2048.)

If you have questions, you can call the Mass General Brigham Medicare ACO hotline at 1-800-229-0384.

Mass General Brigham MassHealth ACO

Important update about upcoming changes to Mass General Brigham ACO with Mass General Brigham Health Plan 

Mass General Brigham MassHealth ACO is a health plan for MassHealth members offered by Mass General Brigham and Mass General Brigham Health Plan. It is an Accountable Care Organization or “ACO.” An ACO is a team of doctors, nurses, and other providers who work together to provide coordinated, high-quality care for members. The Mass General Brigham MassHealth ACO offers the same benefits as MassHealth (the Massachusetts Medicaid program).

Our goal is to make sure that you have access to the doctors and caregivers that you need to improve your overall health. A Mass General Brigham ACO PCP will coordinate your care, and you will have access to additional benefits, support programs, and services.

On April 1, Mass General Brigham and Mass General Brigham Health Plan started working together in the new Mass General Brigham ACO.

Visit MassgeneralBrighamHealthPlan.org for details about the Mass General Brigham ACO.