Just three or four years ago, accountable care organizations (ACOs) were still being compared to the mythical unicorn — an intriguing idea, but one impossible to see in reality. Today, ACOs are very much a reality, with roughly 750 ACOs across the nation serving 23.5 million people insured by Medicare, Medicaid, and commercial insurance. This evolving model strives to fulfill the Triple Aim of better health, improved patient experience, and lower costs by shifting more accountability for health outcomes to providers. While not all ACOs have been able to deliver better outcomes at lower costs, many have been able to realize these goals.

This brief, made possible through support from the Robert Wood Johnson Foundation, explores promising trends, emerging opportunities, and potential barriers identified by ACO stakeholders across the country. This brief examines how ACOs can build upon initial successes and informs policymakers, researchers, and foundations about key considerations to further the development of effective ACO approaches across the health care market.