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Accountable Care Organizations (ACOs) are growing, but pediatric ACOs face unique challenges. This study identifies key issues and opportunities to guide future development in pediatric ACOs.

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Area of Science:

  • Healthcare Management
  • Pediatric Health Services
  • Health Policy

Background:

  • The Affordable Care Act has spurred growth in Accountable Care Organizations (ACOs).
  • Pediatric ACOs have experienced slower growth compared to those for adult populations.
  • Understanding challenges and opportunities in pediatric ACOs is crucial for their development.

Purpose of the Study:

  • To investigate the formation and sustainability of pediatric Accountable Care Organizations (ACOs).
  • To identify key issues and opportunities for pediatric ACOs.
  • To provide insights for future pediatric ACO development.

Main Methods:

  • Conducted a study on pediatric ACOs in collaboration with Leavitt Partners, LLC.
  • Performed a series of 5 case studies of diverse pediatric ACO models.
  • Scanned Medicaid ACOs and convened a leadership summit on pediatric ACO development.

Main Results:

  • Identified several challenges impacting the formation and sustainability of pediatric ACOs.
  • Outlined opportunities for the pediatric community in areas such as organization, payment, quality, and technology.
  • Highlighted the need for tailored strategies to foster pediatric ACO growth.

Conclusions:

  • Pediatric ACOs require specific strategies to overcome formation and sustainability hurdles.
  • Opportunities exist to advance pediatric ACOs through organizational innovation, payment reform, and technological integration.
  • The findings offer guidance for enhancing the future of pediatric ACO development.