VIEWPOINT Can Accountable Care Organizations Improve Population Health? Should They Try? Talking about ACOs as if they are focusing on improv- Douglas J. Noble, MD, MPH ing population health—as opposed to improving medical Lawrence P. Casalino, MD, PhD care for their populations of patients—leads to a lack of clar- ity about what ACOs are doing and about population health HE NUMBER OF ACCOUNTABLE CARE ORGANIZATIONS and may divert attention away from social and public health (ACOs) increased rapidly during 2012. There are services and from socioeconomic factors critical to health. now more than 250. This increase is likely to ac- It would be unfortunate if ACOs, which have been con- Tcelerate: commercial health insurers are signing ceived in idealistic terms, were to result in a narrowing and ACO-like contracts with health care organizations, and the medicalization of the phrase “population health.” return of President Obama to the White House, as well as Currently, ACOs lack the incentives and, in most cases, the Supreme Court ruling upholding the Affordable Care the capabilities to be responsible for population health de- Act (ACA), have removed uncertainty about the Medicare fined as the health of everyone in their geographic area. ACOs ACO program.
JAMA – American Medical Association
Published: Mar 20, 2013