ACO Contracts With Downside Financial Risk Growing, But Still In The Minority

Kristen A Peck; Benjamin Usadi; Alexander J Mainor; Elliott S Fisher; Carrie H Colla

doi:10.1377/hlthaff.2018.05386

ACO Contracts With Downside Financial Risk Growing, But Still In The Minority

Health Aff (Millwood). 2019 Jul;38(7):1201-1206. doi: 10.1377/hlthaff.2018.05386.

Authors

Kristen A Peck¹, Benjamin Usadi², Alexander J Mainor³, Elliott S Fisher⁴, Carrie H Colla⁵

Affiliations

¹ Kristen A. Peck is a research project director at the Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, in Lebanon, New Hampshire.
² Benjamin Usadi is an analytic project coordinator at the Dartmouth Institute for Health Policy and Clinical Practice.
³ Alexander J. Mainor is a research project manager at the Dartmouth Institute for Health Policy and Clinical Practice.
⁴ Elliott S. Fisher is a professor at the Dartmouth Institute for Health Policy and Clinical Practice.
⁵ Carrie H. Colla ( carrie.h.colla@dartmouth.edu ) is an associate professor at the Dartmouth Institute for Health Policy and Clinical Practice.

Abstract

Success of the accountable care organization (ACO) model may require stronger financial incentives, such as including downside risk in contracts. Using the National Survey of ACOs, we explored ACO structure and contracts in 2012-18. Though the number of ACO contracts and the proportion of ACOs with multiple contracts have grown, the proportion bearing downside risk has increased only modestly.

Keywords: ACO Contracts; Accountable Care Organizations; Downside Risk; National Survey of ACOs; Risk-Sharing; Value Based Healthcare; payment reform.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Accountable Care Organizations* / economics
Accountable Care Organizations* / statistics & numerical data
Contracts*
Humans
Medicare / statistics & numerical data*
Risk Factors
United States

Abstract

Publication types

MeSH terms

Grants and funding