Accountable care organizations (ACOs), once compared to mythical creatures, are now a widespread reality, with roughly 750 ACOs serving 23.5 million Medicare, Medicaid, and commercially insured patients across the United States. These models are designed to improve quality of care and reduce costs through a combination of delivery system reforms and value-based payment methodologies. While not all ACOs have been successful at realizing these goals, some clearly have. ACOs participating in the Medicare Shared Savings Program, Pioneer ACO program, state Medicaid ACO programs, and some commercial arrangements have achieved significant savings while improving quality of care and patient experience.

In this Health Affairs blog post, CHCS’ Rob Houston and Tricia McGinnis join Andrea Ducas of the Robert Wood Johnson Foundation and Stephen Shortell of the University of California-Berkeley to describe key ACO trends, detail emerging opportunities for ACOs to fulfill their promise, and consider next steps for the movement toward accountable care.


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