Accountable Care Organizations – AHA Research Synthesis Report
What are ACOs?
The term Accountable Care Organization (ACO) describes the development of partnerships between
hospitals and physicians to coordinate and deliver efficient care (Fisher, 2006). The ACO concept
envisions multiple providers assuming joint accountability for improving health care quality and slowing
the growth of health care costs. The concept was also included in national health care reform legislation
as one of several demonstration programs to be administered by Medicare (Patient Protection and
Affordable Care Act, 2010). However, ACOs described in health reform legislation are operationally
different from other ACO models. The role of ACOs in integrating and aligning provider incentives in care
delivery requires participating organizations to posses certain key competencies, as identified in the
Competencies for ACOs
1. Leadership x N/A
2.Organizational culture of
teamwork N/A x N/A x N/A x
3.Relationships with other
providers x x x x x x
4.IT infrastructure for population
management and care
xx xxx x
5.Infrastructure for monitoring,
managing, and reporting
xx xxx x
6.Ability to manage financial risk N/A x x x x x
7.Ability to receive and distribute
payments or savings x x x x x x
8.Resources for patient
education and support x x N/A x N/A N/A
Information on the impact of ACOs is limited and points to key questions that still need to be answered as
both the federal and private sectors prepare for widespread implementation of the model.
Key Questions to Consider
The following are key questions to consider in the development and implementation of ACOs.
1. What are the key competencies required of ACOs?
2. How will ACOs address physician barriers to integration?
3. What are the legal and regulatory barriers to effective ACO implementation?
4. How can ACOs maintain patient satisfaction and engagement?
5. How will quality benchmarks be established?
6. How will savings be shared among ACOs?