Author Affiliations: Dartmouth Institute for Health Policy and Clinical Practice, Hanover, New Hampshire (Dr Fisher); and Division of Health Policy and Management, School of Public Health, University of California, Berkeley (Dr Shortell).
Interest in accountable care organizations (ACOs) has increased dramatically with the passage of the Affordable Care Act, which establishes ACOs as a new payment model under Medicare and fosters pilot programs to extend the model to private payers and Medicaid. Proponents hope that ACOs will allow physicians, hospitals, and other clinicians and health care organizations to work more effectively together to both improve quality and slow spending growth.1 Skeptics are concerned that ACOs will focus narrowly on their bottom line and either stint on needed care or use the leverage they achieve through local integration to demand unreasonable prices from payers.
Elliott S. Fisher, Stephen M. Shortell. Accountable Care OrganizationsAccountable for What, to Whom, and How. JAMA. 2010;304(15):1715–1716. doi:10.1001/jama.2010.1513