The evolution of ACOs and what it may look like in the future [Special Report]

By Zack Budryk

Accountable care organizations (ACOs) have had early signs of success but the care delivery model continues to undergo changes to meet the needs of providers who strive to improve care and lower costs. 

Despite the frequent changes, the ACO model is definitely here to stay. Indeed, the Department of Health and Human Services' recent announcement that it will tie half of fee-for-service payments to alternative payment models by 2018 has made the model more significant than ever. And despite many exits from the Centers for Medicare & Medicaid Services' Pioneer program, even among its top performers, CMS is betting big on the model, announcing an expansion of Pioneer ACOs after they saved nearly $400 million in the first two years of the program.

The rise of ACOs as a practical model has been nothing short of meteoric, Risa Lavizzo-Mourey, M.D., president and CEO of the Robert Wood Johnson Foundation, told FierceHealthcare in an exclusive interview. 

"In less than five years, ACOs have transformed from an academic idea to a tangible model that has been implemented across the U.S. By realigning financial structures and redirecting care delivery to be more patient-centered, ACOs have given providers more accountability in the care of their patients," Lavizzo-Mourey said.

Quality and cost improvements among ACOs under both Medicare and commercial payers, she added, will encourage growth in the ACO market.

Richard Lopez,, M.D. chief medical officer at Newton, Massachusetts-based Atrius Health, the Northeast's largest nonprofit independent multi-specialty medical group and one of the original Pioneer ACOs, agreed, noting that the ACO model grew faster than anyone in the industry thought possible. "The numbers of ACOs have grown exponentially compared to what people thought a few years ago," he said.

In this special report, FierceHealthcare talks to experts and providers about the evolution of ACOs, the most significant changes to the model and what the future holds.