This article from December 2013 describes a cross-sectional study of all the accountable care organizations (ACOs) in the United States, as of August 2012. The researchers analyzed demographic and health care system characteristics for each ACO and were able to determine which factors were most associated with ACO presence. Many factors, such as competition and number of physician groups available, were found to have varying degrees of influence on ACO formation. For example, if fewer physician groups exist in an area, this may indicate that the groups are larger, leaving more opportunity for the presence of ACOs in a market. The 227 ACOs identified in the study were found to service nearly 1/3 of local areas, with over half of all Americans living in an area with at least one ACO. Furthermore, ACOs differed in their coverage, with most ACOs (37%) centralized in one area, while a full quarter of ACOs served eight or more areas. One indicator that significantly predicted presence of an ACO was an area with higher per capita Medicare costs, as well as those with less acute care beds. Regionally, the northeast featured the most ACOs, along with urban areas and areas of low poverty. This study is one of many that attempt to explain where (and why) ACOs are formed. To this point, this information has been fragmented and difficult to compile for adequate analysis. As more literature emerges that discusses the many different aspects of ACO formation and presence, more detailed analysis can define what factors make ACOs successful in terms of performance and health outcomes.
Lewis, V., et al. (2013). Accountable Care Organizations in the United States: Market and Demographic Factors Associated with Formation. Health Services Research, 48(6), 1840-1858.
By Yara Asi, Florida Accountable Care Service
Published: April 25, 2014