Since the spending targets in Medicare's new accountable care organization (ACO) programs are being set on the basis of national, rather than local, rates of spending growth, ACOs could gain or lose financially without altering their delivery of care.

Global payment could change the perverse incentives inherent in the fee-for-service system. But accountable care organizations that track their member physicians' earnings according to standard fees for service will undermine the purpose of the approach.

Lance Armstrong argues that winning races depends more on athletes' skills, physical conditioning, and effort than on advanced bikes. ACOs are the bikes of health system reform; their success will depend on their enabling organizations to improve underlying performance.

Implementation of accountable care organizations (ACOs) is still at an early stage, but the growing experience with these organizations and the public comments regarding the Medicare ACO program point to five key challenges — and possible approaches to overcoming them.

The Department of Health and Human Services is finalizing the rules for establishing accountable care organizations under the Medicare Shared Savings Program, having made improvements to encourage a more pluralistic set of participants without compromising outcomes.

The mixed results of the Centers for Medicare and Medicaid Services' Physician Group Practice Demonstration project should dampen unreasonable expectations, particularly in terms of potential savings, for accountable care organizations.

In April, the Centers for Medicare and Medicaid Services (CMS) issued a long-awaited Notice of Proposed Rulemaking with a proposed policy for the accountable care organization (ACO) program authorized by the Affordable Care Act (ACA). Under this policy, ...

Community Health Center (CHC)–Academic Medical Partnerships (CHAMPs) would combine academic medical centers' subspecialist expertise, technology, and inpatient care with CHCs' primary care expertise, creating a distinctive form of accountable care organization.

Before the ink was dry on the proposed rule spelling out requirements for accountable care organizations (ACOs) under the Medicare Shared Savings Program, the criticism began coming fast and furious, much of it claiming that the Centers for Medicare and ...

A common criticism of U.S. health care is the fragmented nature of its payment and delivery systems. Because in many settings no single group of participants — physicians, hospitals, public or private payers, or employers — takes full responsibility for ...

The accountable care organization (ACO) model is rather controversial among health care experts. Its proponents tout the potential savings and coordinated care that could be achieved through this model.¹Others, however, point out that the model is not ...

Academic medical centers must address financial and cultural barriers to the implementation of new care and payment models such as ACOs. The steps that Johns Hopkins has taken may offer useful lessons for other academic medical centers.

Is the ACO a suitable model for academic medical centers to pursue as they try to control costs and deliver superior, coordinated care? Given their current culture and structure, academic medical centers will have a difficult time establishing ACOs.

The Medicare Physician Group Practice (PGP) demonstration project was the model for health care reform's accountable care organizations. Results from the fourth year of the PGP project were recently reported by the Department of Health and Human Services.

Hospitals and physicians eagerly await regulations for accountable care organizations (ACOs), which can share in Medicare's savings if they furnish efficient, high-quality care. But many worry that in creating ACOs they risk violating fraud, abuse, and antitrust laws.

Despite the uncertainty and controversy it has generated, the Patient Protection and Affordable Care Act (ACA) has sown the seeds for a major reorganization of the U.S. health care delivery system. In almost every region of the country, hospitals and ...

Improving care coordination under health care reform will require the development of accountable care organizations (ACOs). A crucial question is whether hospitals or physicians will control ACOs — and capture the largest share of any savings they achieve.

An accountable care organization (ACO) model that does not attend to the way patients seek care may fail to achieve its cost-saving and quality goals and may give rise to a backlash. Policymakers should focus on creating incentives to build patients' loyalty to an ACO.

The Patient Protection and Accountable Care Act (ACA) requires the secretary of health and human services to establish a program within Medicare in which savings from efficient, high-value care are shared with accountable care organizations (ACOs). No ...

Under the Affordable Care Act, Medicare will launch a Shared Savings Program for groups of health care providers that join forces, with or without hospitals or health plans, to form legal entities that agree to take responsibility for the quality, cost, ...