ACO Participation Did Not Lower Care Access for Vulnerable Patients

Physician groups did not reduce their share of vulnerable patients after joining an accountable care organization despite claims of the opposite, a new study from the Perelman School of Medicine revealed.

Accountable care organizations (ACOs) are the largest payment reform experimentation, with over 1,000 of the organizations covering more than 32 million patients in 2018, researchers reported. But there are concerns that the incentive structure of the alternative care delivery model reinforces or possibly exacerbates disparities in healthcare quality.

Prior research has shown that ACOs typically form in geographic areas with fewer black residents and lower rates of poverty, fewer uninsured patients, and fewer patients without high school education. Evidence has also demonstrated that ACOs with more medically complex patients and higher-cost physicians and beneficiaries were more likely to drop out of the ACO.

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