NAACOS: A Brief HistoryIn October 2012, a small group of ACO senior executives gathered at a Nashville airport hotel to brainstorm about how best to structure and launch ACOs in response to federal opportunities in Medicare. Over the past decade, the ACO model has evolved from an academic concept to a market-based solution to fragmented and costly care that enables local physicians, hospitals, and other providers to work together and be responsible for improving quality, The history of NAACOS mirrors the rapid growth of ACOs. At the time of NAACOS’ founding, the organization had about 50 members. Today, NAACOS’ members include nearly half of the 700 ACOs that serve an estimated 23 million Americans covered by Medicare, commercial insurance, and Medicaid across local communities in all 50 states. Initially, NAACOS focused on ensuring effective ACO participation in public policy deliberations. With an interim board and just a few staff members, NAACOS CEO Clif Gaus focused on gaining a “seat at the table” in key federal ACO policy discussions. “In Clif, we were fortunate to find a CEO with “ACOs needed an experienced and credible voice in the policy process, and Clif immediately provided that,” said Mike Barrett, Co-founder Cura Management, Inc. Working with the board and the NAACOS ACO member community, Gaus provided sound, consistent, and workable solutions to CMS early in the agency’s ACO policy deliberations. Today, NAACOS members continue to have unprecedented access to leadership at CMS and the Center for Medicare and Medicaid Innovation, for example via “open mic” sessions at NAACOS conferences.
In 2017, recognizing the scarcity of objective science on accountable care strategies, NAACOS provided seed funding to launch the Institute for Accountable Care, a 501(c) (3) nonprofit organization with a mission, first, to build the evidence base on the impact of ACOs on both quality and cost, and second, to identify and disseminate best practices used by ACOs to improve population health. While the Institute will benefit from unique access to NAACOS’ membership, the Institute is a separate organization and conducts Key NAACOS Milestones
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At the time, ACOs were forming rapidly and interacting with the Centers for Medicare & Medicaid Services (CMS), yet ACOs lacked a cohesive voice or even an effective way to exchange ideas. To fill this void, NAACOS was launched to ensure ongoing and sustainable advocacy and education for the ACO industry. Led by founding Board Members Stephen Nuckolls, Mike Barrett, Dr. Tom Graf, Bruce Fried, along with other ACO leaders and experts, NAACOS took shape in just a few months, becoming an effective voice for the ACO community. Throughout its history, NAACOS has remained true to its roots as a group formed by ACOs, governed by ACOs, and wholly focused on ACOs.
enhancing patient experience, and reducing waste to keep care affordable. 
decades of experience working on the forefront of federal health care policy,” said Nuckolls, CEO of Coastal Carolina Health Care, PA, and its ACO, Coastal Carolina Quality Care, Inc.
independent and objective research. The two organizations cooperate on select projects, working with NAACOS members to implement results of research and demonstration projects.