A National Strategy To Put Accountable Care Into Practice
- Mark McClellan ( [email protected] ) is director of the Engelberg Center for Health Care Reform at the Brookings Institution in Washington, D.C. He is also senior fellow, economic studies; and holds the Leonard D. Schaeffer Chair in Health Policy Studies at Brookings.
- Aaron N. McKethan is research director of the Engelberg Center.
- Julie L. Lewis is assistant director for health policy, Center for Health Policy Research, at the Dartmouth Institute for Health Policy and Clinical Practice in Hanover, New Hampshire.
- Joachim Roski is managing director of the High-Value Health Care Project at the Engelberg Center.
- Elliott S. Fisher is director for Population Health and Policy and director at the Dartmouth Institute for Health Policy and Clinical Practice, and a professor of medicine and of community and family medicine at Dartmouth Medical School.
Abstract
The concept of accountable care organizations (ACOs) has been set forth in recently enacted national health reform legislation as a strategy to address current shortcomings in the U.S. health care system. This paper focuses on implementation issues related to these organizations, building on some initial examples. We seek to clarify definitions and key principles, provide an update on implementation in the context of other reforms, and address emerging issues that will affect the organizations’ success. Finally, building on the initial experience of several organizations that are implementing accountable care and complementary reforms, we propose a national strategy to identify and expand successful approaches to accountable care implementation.
