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An “ESCO” or “ESRD Seamless Care Organization” is an Accountable Care Organization (ACO) composed of providers and suppliers who voluntarily come together to form a legal entity that offers coordinated care to beneficiaries with ESRD through the Comprehensive ESRD Care model.  An ESCO is required to have participant owners that include at least one nephrologist or nephrology group practice and at least one dialysis facility.   Our firm has worked with groups of providers on establishing both ESCOs and ACOs around the country.