ACO Formation and Contracting in North Carolina


Practice Areas

Robinson Bradshaw Publication
Jan. 31, 2014

Most public information about ACO formation in North Carolina concerns those ACOs that have contracted with CMS.

CMS has approved the North Carolina entities listed below to participate in federal ACO programs. All of these ACOs are participating in the MSSP, except Coastal Carolina Quality Care, Inc., an eastern North Carolina-based entity that is participating in the Advanced Payment ACO program.

Some of these federally contracted ACOs have also entered into ACO-type reimbursement agreements with private payors. While information on agreements between ACOs and private payors is not necessarily publicly available, the following federally contracted North Carolina ACOs have publicly announced ACO arrangements with private payors:

Several other North Carolina-based providers, while not participating in federal ACO programs, have also begun to enter into innovative agreements with private payors. Under these agreements, the parties operate under a model that requires or provides incentives for a new degree of clinical integration that is similar to ACO-type activity.

According to records of the North Carolina Secretary of State, several entities have been organized in North Carolina with possible plans to operate as ACOs, including the following:

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