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August 16, 2016

Reassessing ACOs and Health Care Reform

Author Affiliations
  • 1Duke University School of Medicine, Durham, North Carolina
  • 2Harvard Business School, Boston, Massachusetts
  • 3Duke University School of Law, Durham, North Carolina
JAMA. 2016;316(7):707-708. doi:10.1001/jama.2016.10874

Has the accountable care organization experiment been successful?—No.

Accountable care organizations (ACOs) were the cornerstone of the novel payment strategies for Medicare reform under the Affordable Care Act (ACA). In an effort to move from fee-for-service medicine, the Centers for Medicare & Medicaid Services (CMS) aimed to encourage hospitals and physicians to collaborate by offering a bonus if they improved the quality and efficiency of care. The ACO concept appeared in 2 different initiatives under the ACA—the Pioneer ACO program and the ACO program under the Centers for Medicare & Medicaid Innovation (CMMI)—and was intended as an experiment in health policy.

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