1. Time to start is now. ACOs must be organized before 2012, when one ACO will be designated in each region, with each region having no less than 5,000 Medicare beneficiaries who have signed up for an ACO. The first organization up and running will have an advantage, because no hospital, physician or other provider can be involved in more than one ACO.
2. Goal is clinical integration. The ACO is expected to save money by integrating care. Providers will need to work closely with each other on the full spectrum of care for each patient.