Related Experiment Videos
Third-Party Convener Firms And The Rise Of Geographically Dispersed, High-Earning Medicare ACOs
Adam A Markovitz1, Jay Shroff2, Andrew Zhang3
1Adam A. Markovitz (amarkov@umich.edu), University of Michigan, Ann Arbor, Michigan.
Health Affairs (Project Hope)
|June 1, 2026
Summary
Third-party conveners are increasingly organizing Accountable Care Organizations (ACOs) in Medicare. These dispersed networks earn more shared savings but show no quality improvements, prompting policy recommendations.
Area of Science:
- Health Policy
- Healthcare Management
- Health Economics
Background:
- Accountable Care Organizations (ACOs) are a key Medicare reform to control healthcare costs.
- ACOs were designed as local, clinically integrated networks for shared patient care.
- Third-party conveners are now central to recruiting clinicians into Medicare Shared Savings Program (MSSP) ACOs.
Purpose of the Study:
- To analyze the impact of third-party conveners on the structure and financial performance of MSSP ACOs.
- To investigate the growth of convener-led and geographically dispersed ACOs.
- To evaluate the relationship between ACO structure (local vs. dispersed, convener-led vs. non-convener-led) and shared savings payments.
Main Methods:
- Analysis of national MSSP data from 2012-2021.
- Examination of beneficiary enrollment in different types of ACOs (convener-led, dispersed).
- Comparison of shared-savings payments across ACO structures, controlling for quality.
Main Results:
- The proportion of beneficiaries in convener-led ACOs increased from 11% to 23% between 2012 and 2021.
- The share of beneficiaries in dispersed ACOs, particularly among convener ACOs, rose significantly from 13% to 42%.
- Dispersed convener ACOs achieved the highest shared-savings payments ($171/beneficiary/year), while local convener ACOs earned the least ($95/beneficiary/year), with no demonstrable difference in quality.
Conclusions:
- Third-party conveners are fundamentally altering the landscape and structure of the MSSP.
- The financial success of dispersed, convener-led ACOs raises questions about care coordination effectiveness.
- Policy interventions are recommended to enhance transparency of convener relationships and refine network definitions to foster genuine coordinated care.
Related Concept Videos
01:29Issues And Trends In Healthcare Delivery System
The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
01:18Healthcare Agencies I
Healthcare agencies provide healthcare services to people. In the United States, voluntary agencies are often non-profit centers sponsored by donations, grants, or fundraisers. One such organization is Meals on Wheels, which provides meals to the elderly and homebound. The American Heart Association and the American Lung Association are other non-profit community organizations. Doctors and nurses are frequently active members of these organizations, which offer health checks and educational...
01:17Healthcare Agencies II
There are various healthcare agencies in the United States—some of which are managed by religious institutions and others by different government branches.
Parish nursing is a growing specialty nursing profession that focuses on holistic healthcare, health promotion, and illness prevention. It blends professional nursing practice with a health ministry, focusing on health and healing within the context of a Christian community. Parish nurses serve as health educators, referral sources, and lay...
Parish nursing is a growing specialty nursing profession that focuses on holistic healthcare, health promotion, and illness prevention. It blends professional nursing practice with a health ministry, focusing on health and healing within the context of a Christian community. Parish nurses serve as health educators, referral sources, and lay...
01:29Documentation in Long-Term and Home Healthcare Setting
Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities
Long-Term Care Facilities
01:26Methods Of Healthcare Delivery System
At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
01:20Integrated Healthcare System
An integrated healthcare system (IHS) is a set of organizations that provides for or arranges to provide coordinated and continuous service to a defined population. The IHS takes responsibility for that particular population's health status and outcome, both clinically and fiscally. An integrated healthcare system is a well-organized, well-coordinated, and collaborative network. The integrated delivery system is a network that connects different healthcare providers to deliver organized,...