Cited by 174Healthcare Policy and ManagementPrimary Care and Health OutcomesPatient Satisfaction in Healthcare

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Impact of Accountable Care Organizations on Utilization, Care, and Outcomes: A Systematic Review

Kaufman, Brystana G., Spivack, B. Steven, Stearns, Sally C., Song, Paula H., O’Brien, Emily C.·2019·Medical Care Research and Review

DOI 10.1177/1077558717745916

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Abstract

Since 2010, more than 900 accountable care organizations (ACOs) have formed payment contracts with public and private insurers in the United States; however, there has not been a systematic evaluation of the evidence studying impacts of ACOs on care and outcomes across payer types. This review evaluates the quality of evidence regarding the association of public and private ACOs with health service use, processes, and outcomes of care. The 42 articles identified studied ACO contracts with Medicare ( N = 24 articles), Medicaid ( N = 5), commercial ( N = 11), and all payers ( N = 2). The most consistent associations between ACO implementation and outcomes across payer types were reduced inpatient use, reduced emergency department visits, and improved measures of preventive care and chronic disease management. The seven studies evaluating patient experience or clinical outcomes of care showed no evidence that ACOs worsen outcomes of care; however, the impact on patient care and outcomes should continue to be monitored.

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“Similar to ACOs, P4P programs have been associated with small positive effects on the process measures targeted; however, neither model has demonstrated consistent effects on health outcomes (Flodgren et al., 2011; Gilmore et al., 2007; Lin, Yin, Huang, & Du, 2016; Mendelson et al., 2017; Rosenthal & Frank, 2006; Rose…”
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Authors: Kaufman, B. G., Spivack, B. S., Stearns, S. C., Song, P. H., & O’Brien, E. C.
Affiliations: University of North Carolina at Chapel Hill (US)
University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
Duke Clinical Research Institute, Durham, NC, USA
Corresponding author: Kaufman, Brystana G.
ORCID: Kaufman, Brystana G.
Stearns, Sally C.
Song, Paula H.
Venue: Medical Care Research and Review
Publisher: SAGE Publications
Published: 2017-12-12
Volume: 76
Issue: 3
Pages: 255-290
ISSN: 1077-5587 (ISSN-L)
1552-6801
DOI: 10.1177/1077558717745916
OpenAlex: W2774554851
Cited by: 174
References: 78
Citations by year: 2026: 12 · 2025: 24 · 2024: 27 · 2023: 22 · 2022: 29 · 2021: 17 · 2020: 22 · 2019: 16 · 2018: 5
FWCI: 4.04
Type: journal article
Language: en
Open access: closed
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Medical Care Research and Review (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (TL1TR001110)
Topics: Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
Health Sciences › Medicine › Family Practice › Primary Care and Health Outcomes
Health Sciences › Health Professions › General Health Professions › Patient Satisfaction in Healthcare
Keywords: accountable care organizations, health care payment reform, Medicare, Medicaid, private insurance, health care utilization, emergency department visits, preventive medicine, chronic disease management, patient experience, clinical outcomes, quality of care
MeSH terms: Emergency Service, Hospital, Medicare, Hospitalization, Humans, Medicaid, Patient Acceptance of Health Care, Preventive Medicine, Quality of Health Care, United States, Outcome Assessment, Health Care, Disease Management, Accountable Care Organizations

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Impact of Accountable Care Organizations on Utilization, Care, and Outcomes: A Systematic Review

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