Two-thirds of Americans live in areas served by the 500 accountable care organizations (ACOs) that now exist across the country, according to a report from Oliver Wyman consulting firm.
Overall, ACOs serve between 46 and 52 million Americans, or between 15 and 17 percent of the population, according to the report, "ACO Update: Accountable Care at a Tipping Point." About 10 percent of Medicare beneficiaries, or 5.3 million people, receive care from ACOs, up from about 4 million in July 2013.
"ACOs need to be treated as a triggering mechanism for a revolution in American healthcare. Their reach is at least as important a factor to watch as their current enrollments," writes Niyum Gandhi, a partner in Oliver Wyman's Health & Life Sciences practice group and one of the firm's ACO experts.
Because ACOs are in early development stages and are reimbursed differently than traditional fee-for-service providers, they can profit from eliminating unnecessary services and focusing on preventive care, Gandhi said. However, he posed the question, When will we see the kind of competition that leads to meaningful change?
The firm classified the more than 370 Medicare ACOs as healthcare providers that participate in the Pioneer ACO program, the Medicare Shared Savings Program, a Medicaid ACO or the Physician Group Practice (PGP) Transition program, according to the report.
However, they classified the 150-plus non-Medicare ACOs by whether they had at least one shared-savings or shared-risk arrangement with at least one commercial payer but not the Centers for Medicare & Medicaid Services. However, researchers noted that the information may be imperfect because they gathered data from press releases, news accounts and other research.
With a push for higher quality, cost-effective care, the number of ACOs is expected to double nationwide by the end of 2014, FierceHealthcare previously reported.
To learn more:
- here's the ACO report (.pdf)