Accountable Care Organizations: Can We Have Our Cake and Eat it Too?

Abstract

Proponents of accountable care organizations (ACOs) claim that ACOs can lower health care costs without diminishing quality. Although ACOs clearly can reduce costs without sacrificing quality through the elimination of wasteful medical interventions and better patient management, the opportunities for ACOs to achieve savings without adversely impacting patient care likely are far fewer than their supporters contend. In the long-term, then, ACOs do not present a painless solution to the challenge of rising health care costs. If ACOs are to effectively slow down health care inflation, they can only do so if they make some compromises in the quality of care they provide patients, that is, they must ration care.

Keywords: accountable care organizations (ACOs), health law, health policy, health regulation, wasteful medical care, chronic care, health care costs, health care rationing, fee-for-service, health care quality, health care performance measures