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March 12, 2014

Shared Savings in Accountable Care Organizations: How to Determine Fair Distributions

Author Affiliations
  • 1Berman Institute of Bioethics and Division of General Internal Medicine, Johns Hopkins University, Baltimore, Maryland
  • 2Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
JAMA. 2014;311(10):1011-1012. doi:10.1001/jama.2014.498

Accountable care organizations (ACOs) are playing a major role in health care reform. In the last 2 years alone, Medicare ACOs have proliferated to cover more than 5 million Medicare beneficiaries in more than 360 organizations nationwide.1 In ACOs, individual clinicians (including physicians, physician assistants, and nurse practitioners, among others), group practices, and, in some cases, hospitals contract with payers to be jointly accountable for the health outcomes and expenditures of a defined patient population. By meeting specified quality measures while keeping expenditures below defined benchmarks, ACOs share in the monetary savings generated.