Accountable Care Organizations Now Serve 14% Of Americans

More than half of the U.S. population now live in localities served by accountable care organizations and almost 30 percent live in areas served by two or more.

The figures come from a new analysis by the consulting firm Oliver Wyman, based on the Department of Health and Human Services’ announcement of the latest class of Accountable Care Organizations (ACOs) approved to participate in Medicare’s ACO programs. The latest round of approvals in January brings the total of Medicare ACOs to 259, up from 154 this past summer. The new additions contribute to a sharply rising potential level of influence for ACOs.
  • According to the Centers for Medicare and Medicaid Services (CMS), about 4 million Medicare beneficiaries, or about 11 percent of total Medicare fee-for-service beneficiaries, will now receive their healthcare from ACOs. The corresponding figures in September were 2.4 million and 6 percent.
  • Most of these Medicare ACOs also serve non-Medicare patients and are moving toward serving all their patients under ACO arrangements. That transition can take as long as four to five years. That said, the current number of patients served by the newly approved Medicare ACOs (including both patients currently under an ACO arrangement and those served through traditional contracts with payers) has risen by about 12 million, bringing the total number of patients served by Medicare-approved ACOs to 29 million.
  • The total number of patients in organizations with ACO arrangements with at least one payer—both Medicare and non-Medicare—is now between 37 and 43 million, up from 25 to 31 million—or roughly 14 percent of the population.

“It’s hard to know precisely how many people served by ACOs are currently cared for under true fee-for-value contracts,” says Rick Weil, a partner in Oliver Wyman’s Health & Life Sciences practice group who has worked extensively in creating ACOs. “Most ACOs today are still mixed models, with some patients being served through ACO-style or capitated contracts and some through more traditional fee-for-service contracts. It can take several years to shift an entire population from one model to another. But that total number of patients served by these mixed organizations is still important.”

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