Hospitals involved in ACOs are mostly large, urban

Hospitals that participate in accountable care organizations (ACOs) are disproportionately large, urban facilities, according to a study published in Health Affairs.

Researchers from the Dartmouth Institute for Health Policy and Clinical Practice analyzed data from the Leavitt Partners ACO Database as well as the National Survey of Accountable Care Organizations to examine common features of participating hospitals. Their research determined the hospitals most likely to have ACO contracts were large and in urban areas. More than 2 of 3 participating hospitals were located in either the Pacific or Eastern regions.

The researchers also found:

  • One-fifth of U.S. hospitals belonged to an ACO as of 2014
  • Non-participating hospitals were slightly more likely than participants to serve impoverished patients, with 13 percent of ACO participants' local populations below the federal poverty level compared to 16 percent of non-participants
  • Teaching hospitals and hospitals with broad ranges of service were more likely to participate in ACOs than those with more limited services
  • Short-term acute care providers were far more likely to participate in ACOs than specialty or critical access hospitals, comprising 85 percent of participants

Researchers also found numerous advantages to ACO participation in their analysis for both providers and ACOs. For example, most representatives of hospital ACOs said the hospital was a beneficial capital source for the ACO.

They also found participation offers numerous other advantages, including the opportunity to share data between inpatient and outpatient settings, and the opportunity to ensure care quality and keep costs down by aligning financial incentives across care settings. Such strategies helped ACOs such as Wisconsin's Integrated Health Network considerably improve patient outcomes, FierceHealthcare previously reported. However, other ACO partnerships have reported difficulties, such as an ACO formed between Johns Hopkins Medicine, three medical practices and a number of Baltimore/Washington hospitals.

To learn more:
- read the study abstract

Read more on