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What Can Canada Learn From Accountable Care Organizations: A Comparative Policy Analysis.

Allie Peckham1,2, David Rudoler3,4,5, Dominika Bhatia2,3

  • 1Center for Innovation in Healthy and Resilient Aging, Edson College of Nursing and Health Innovation, Arizona State University, 550 North 3rd St, Phoenix, Arizona, 85004, USA.

International Journal of Integrated Care
|April 28, 2022
PubMed
Summary

Accountable Care Organizations (ACOs) could be adapted in Canada, but require significant reforms. Key elements for success include physician leadership, global budgets, and collaborative care models for integrated health systems.

Keywords:
Accountable care organizationsCanadaUnited Statescomparative policy analysisintegrated care modelsnarrative review

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Area of Science:

  • Health Services Research
  • Comparative Health Systems Analysis

Background:

  • Accountable Care Organizations (ACOs) are US models designed to reduce healthcare costs and integrate care.
  • Canadian governments are exploring ACO adoption for care integration, but lack comparative studies on transferability.
  • Existing Canadian health systems require significant adaptation to support ACO-like structures.

Purpose of the Study:

  • To examine the applicability and transferability of US-based Accountable Care Organization (ACO) models to Canadian health systems.
  • To identify key factors associated with successful ACO implementation in the US.
  • To assess the necessary reforms within Canada to support ACO adoption.

Main Methods:

  • A narrative literature review of empirical studies evaluating US ACO impacts (2011-2020).
  • Thematic analysis and critical appraisal to identify success factors for ACOs.
  • Comparative analysis of identified ACO success factors with the Canadian healthcare context.

Main Results:

  • Physician-led structures, global budgets, financial incentives, and collaborative care are crucial for optimizing ACO impacts.
  • Canada has initiated reforms toward alternative payments and team-based care.
  • Substantial reforms in physician remuneration, intersectoral collaboration, and performance accountability are needed for ACO implementation in Canada.

Conclusions:

  • ACO-like models show potential for Canadian healthcare, but require significant systemic reforms.
  • Further comparative research beyond the US is essential to determine the core components of successful ACOs.