An Empirical Insight: Accountable Care Organizations’ Profitability and Quality Drivers

Since their inception in 2012, accountable care organizations (ACOs) have yielded inconsistent and unpredictable financial results. These outcomes may be related to an individual ACO’s participant mix of primary care physicians (PCPs) and specialists. We analyzed ACO performance data to better understand the cooperative roles of PCPs and specialists in financially successful ACOs. The dataset included several variables reflecting different quantitative and qualitative characteristics of ACO performance. The analyses of variance and covariance (ANOVA and ANCOVA) were used as the primary statistical tool. The obtained results provided the evidence that a larger number of PCPs in an ACO can help to achieve quantitative goals related to immediate financial effect. In contrast, ACOs with a higher relative share of specialists tend to improve the healthcare quality and profitability in the longer term. The results provide a solid basis for further investigation that may help future ACOs to design the strategies resulting in efficient quality care and sustainable profitability.