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A framework for evaluating the formation, implementation, and performance of accountable care organizations
Elliott S Fisher1, Stephen M Shortell, Sara A Kreindler
1Center for Population Health, Dartmouth Institute for Health Policy and Clinical Practice, Hanover, New Hampshire, USA. Elliott.S.Fisher@dartmouth.edu
Health Affairs (Project Hope)
|November 7, 2012
Summary
Accountable care organizations (ACOs) are rapidly expanding. Understanding factors influencing ACO formation, implementation, and performance is crucial for optimizing this healthcare model and guiding future policy and provider strategies.
Area of Science:
- Health Services Research
- Healthcare Policy and Management
Background:
- Accountable Care Organizations (ACOs) represent a significant shift in healthcare payment and delivery.
- The rapid implementation of ACOs necessitates understanding key influencing factors for success.
Purpose of the Study:
- To identify critical factors affecting ACO formation, implementation, and performance.
- To propose a framework for an ACO evaluation program to inform policymakers, payers, and providers.
- To outline near-term activities for effective ACO evaluation.
Main Methods:
- Analysis of early ACO experiences and influencing factors (contract characteristics, organizational structure, capabilities, activities, local context).
- Development of a proposed structure for an ACO evaluation program.
- Identification of key activities for ongoing ACO evaluation.
Main Results:
- Key factors influencing ACO success include contract specifics, organizational attributes, and the local environment.
- A structured evaluation program can guide improvements in ACO contract design and care transformation strategies.
- Near-term evaluation requires tracking formation, developing performance measures, data aggregation, and coordinated research.
Conclusions:
- Effective evaluation of ACOs is essential for refining healthcare delivery models.
- Policy and provider guidance can be enhanced through a comprehensive understanding of ACO performance drivers.
- Coordinated evaluation efforts will support the ongoing development and success of ACOs.
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