The DOI matches its Crossref record; 78 of the 78 references it cites were found in a registry or an index.
Impact of Accountable Care Organizations on Utilization, Care, and Outcomes: A Systematic Review
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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“In addition, duplication (and costs) may be reduced when relevant information, such as the results of a recent CT scan, is made available to care managers and clinicians [57].”
From Evolution of clinical Health Information Exchanges to population health resources: a case study of the Indiana network for patient care (2025) · cites this paper as [57]
Citations
Cites
1 retracted
Colla, C. H., Lewis, V. A., Kao, L., O’Malley, A. J., Chang, C., & Fisher, E. S. (2016) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2016.2827 · Cited by 116
RetractedThe American Journal of Managed Care
(2020) · The American Journal of Managed Care · doi:10.37765/ajmc · Cited by 3,254
Setting Value-Based Payment Goals — HHS Efforts to Improve U.S. Health Care
Burwell, S. M. (2015) · New England Journal of Medicine · doi:10.1056/nejmp1500445 · Cited by 957
Early Experience With Pay-for-Performance
Rosenthal, M. B., Frank, R. G., Li, Z., & Epstein, A. M. (2005) · JAMA · doi:10.1001/jama.294.14.1788 · Cited by 635
Flodgren, G., Eccles, M. P., Shepperd, S., Scott, A., Parmelli, E., & Beyer, F. R. (2011) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd009255 · Cited by 418 · cited 2×
“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…”
BackgroundResultEarly Performance of Accountable Care Organizations in Medicare
McWilliams, J. M., Hatfield, L. A., Chernew, M. E., Landon, B. E., & Schwartz, A. L. (2016) · New England Journal of Medicine · doi:10.1056/nejmsa1600142 · Cited by 399
A National Strategy To Put Accountable Care Into Practice
McClellan, M., McKethan, A., Lewis, J. L., Roski, J., & Fisher, E. S. (2010) · Health Affairs · doi:10.1377/hlthaff.2010.0194 · Cited by 385
The Effects of Pay-for-Performance Programs on Health, Health Care Use, and Processes of Care
Mendelson, A., Kondo, K. K., Damberg, C. L., Low, A., Motu’apuaka, M. L., Freeman, M., O'Neil, M. E., Relevo, R., & Kansagara, D. L. (2017) · Annals of Internal Medicine · doi:10.7326/m16-1881 · Cited by 374
Pay for Performance in Commercial HMOs
Rosenthal, M. B., Landon, B. E., Normand, S. T., Frank, R. G., & Epstein, A. M. (2006) · New England Journal of Medicine · doi:10.1056/nejmsa063682 · Cited by 359
What Is the Empirical Basis for Paying for Quality in Health Care?
Rosenthal, M. B., & Frank, R. G. (2006) · Medical Care Research and Review · doi:10.1177/1077558705285291 · Cited by 356
Research works printed but not linked: 15
- Ackerman R., 2006, Evaluating statewide disease management programs
- Brennan A., 2016, ACOs at a crossroads: Costs, risk and MACRA
- Green L., 2016, Evaluation of CMMI Accountable Care Organizations Initiative
- Green L., 2016, Evaluation of CMMI Accountable Care Organization Initiatives
- Kautter J., 2012, Evaluation of the Medicare Physician Group Practice Demonstration: Final Report
- Lewis V. A., 2014, American Journal of Managed Care, 20, 1008
- Marcoux R. M., 2012, P & T Pharmacy and Therapeutics, 37, 629
- Muhlestein D., 2015, Projected growth of accountable care organizations
- Muhlestein D., 2016, American Journal of Managed Care, 22, e241
- 10.1377/hblog20140530.039242 · DOI
- Singh S., 2015, Journal of Medical Practice Management, 30, 261
- U.S. Government Accountability Office, 2015, Results from the first two years of the pioneer accountable care organization model
- Walker D. M., 2016, American Journal of Management Care, 22, 802
- Weil T. P., 2012, Journal of Medical Practice Management, 27, 263
- Zutshi A., 2013, The medical home: What do we know, what do we need to know? A review of the earliest evidence on the effectiveness of the patient-centered medical home model
Cited by
Sorted by citations
Heeringa, J. W., Mutti, A., Furukawa, M. F., Lechner, A., Maurer, K. A., & Rich, E. C. (2020) · International Journal of Integrated Care · doi:10.5334/ijic.4635 · Cited by 92
Cattel, D., & Eijkenaar, F. (2019) · Medical Care Research and Review · doi:10.1177/1077558719856775 · Cited by 99
The Future of Healthcare and Patient-Centric Care
Aminabee, S. (2024) · Advances in healthcare information systems and administration book series · doi:10.4018/979-8-3693-1214-8.ch012 · Cited by 92
Health Care Spending on Respiratory Diseases in the United States, 1996–2016
Duan, K. I., Birger, M. L., Au, D. H., Spece, L. J., Feemster, L. C., & Dieleman, J. L. (2022) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.202202-0294oc · Cited by 70
Value-Based Purchasing Design And Effect: A Systematic Review And Analysis
Pandey, A., Eastman, D., Hsu, H., Kerrissey, M. J., Rosenthal, M. B., & Chien, A. T. (2023) · Health Affairs · doi:10.1377/hlthaff.2022.01455 · Cited by 52
Metadata
- 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.
- 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
- 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
- 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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