What is the term for the shared arrangement in an ACO for gains and losses among members for certain Medicare beneficiaries?

The term that refers to the shared arrangement in an Accountable Care Organization (ACO) for gains and losses among members for certain Medicare beneficiaries is gainsharing. Gainsharing specifically involves a financial incentive mechanism that allows health care providers within the ACO to share the savings they generate for patients while also accepting some risk if costs exceed expectations.

Gainsharing is significant in ACOs because it aligns the financial interests of different providers, encouraging them to collaborate effectively in managing patient care. By sharing both the financial gains and losses, ACO members are motivated to improve care quality and reduce unnecessary spending, which is a core principle of the ACO model aimed at enhancing overall patient care while controlling costs.

The other terms like co-management, joint venture, and risk adjustment, while related to various aspects of healthcare operations and financial arrangements, do not specifically capture the essence of the shared financial arrangement for gains and losses among ACO members as gainsharing does. Co-management typically refers to partnerships between physicians and hospitals to improve healthcare outcomes, joint ventures are usually between distinct organizations for a specific project, and risk adjustment pertains more to adjusting payment models based on patient risk factors rather than the sharing of gains and losses. Thus, gainsharing is the most accurate term in this context.