Reassessing ACOs and Health Care Reform

Accountable care organizations (ACOs) were the cornerstone of the novel payment strategies for Medicare reform under the Affordable Care Act (ACA). The ACO initiative was intended as an experiment in health policy, and according to recent findings, the experiment so far has failed to produce needed efficiencies. This begs the important question of whether the theory underlying the ACO strategy is sound. We review recent findings, repeat prior warnings that ACOs could harm competition by consolidating provider markets, and recommend that CMS pursue innovative models of health care delivery that do not rely on high-cost infrastructures that form the backbone of too many ACOs