A New Elephant is in the ACO Waiting Room: It is Following the Money

Several years ago in the early days of Accountable Care Organizations (ACOs), we worried and warned about the importance of how each organization should divide up potential savings. In a white paper published in Physician Leadership Journal and on the Salient Web site, co-author Stephen Sheiko and I called it an “Elephant in the ACO Waiting Room.” In fact, today a new elephant is in the waiting room, and he is trumpeting a different warning message. The message is still about money; however, the elephant is warning about how much money is saved for the payer rather than how it is divided in the ACO. In 2018 ACOs generated net savings of $739.4 million during the year. In the most recently measured year, 2019, ACOs generated $1.2 billion net savings.While this is an improvement, it still begs the same question–is it enough?

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