Accountable Care Organizations Case Studies

Accountable Care Organizations (ACOs) have been heralded as a promising model for improving the quality of care and reducing unnecessary costs through coordination and collaboration among providers. The concept envisions a transformation in the way that care is organized and delivered across the continuum. The following reports share the experiences and lessons learned from four organizations that have embarked on this journey.

The Work Ahead: Activities and Costs to Develop an Accountable Care Organization
This report identifies a total of 23 different capabilities that must be developed across four categories to achieve this transformation: 1) network development and management; 2) care coordination, quality improvement and utilization management; 3) clinical information systems; and 4) data analytics. The costs associated with developing these capabilities range from $5.3 to $12.0 million for two prototype ACOs. The AHA called attention to the discrepancy between these findings and the Centers for Medicare and Medicaid Services' (CMS) proposed rule estimates of the required level of investment in a Letter to administrator Donald Berwick, M.D., M.P.P.

AHA Press Release: New Study Finds the Start Up Costs of Establishing an ACO to be Significant

From Volume to Value: The Transition to Accountable Care Organizations
This report provides a synthesis of the issues and challenges encountered by the four organizations as they have positioned themselves to be accountable for the care of defined populations.

Individual Case Studies:

Clinical Integration