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Lessons from the Field: Making Accountable Care Organizations Real

NIHCR Research Brief No. 2
January 2011
Timothy K. Lake, Kate A. Stewart, Paul B. Ginsburg

Policy makers hope that the development of accountable care organizations (ACOs)—organized groups of physicians, hospitals or other providers jointly accountable for caring for a defined patient population—can improve health care quality and efficiency. An examination of existing provider efforts to improve care delivery illustrates that substantial financial and time investments are required to accomplish changes in care delivery, even among groups of providers affiliated with one another for many years, according to a new qualitative research study from the Center for Studying Health System Change (HSC). A common challenge for health care organizations’ efforts to improve care—similar to what the ACO concept seeks to encourage—is implementing changes with minimal disruption to patients and productivity. To achieve improvements in care delivery, the seven provider organizations studied tapped existing financial reserves or external grant funding. They also sought strong physician and organizational leadership and encouraged transparency and flexibility when making changes. As payers develop guidelines to contract with ACOs, they will need to support providers’ capability to develop and sustain improvements in care delivery, such as new health information technology and data reporting systems.

This Research Brief can be accessed at the National Institute for Health Care Reform Web site.





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