The impact of accountable care organizations.

Date of Award


Document Type



Caspersen School of Graduate Studies

Degree Name

Doctor of Medical Humanities


This dissertation examines how Accountable Care Organizations [ACOs] are integrating with other types of providers such as social services, behavioral health and long term care organizations to address a full range of patient needs in order to achieve an improvement in the health outcomes of a population of patients. It is a study to determine how ACOs integrate with other providers and what the results are for patients. The Patient Protection and Affordable Care Act [PPACA] created a new model of health care delivery called the Accountable Care Organization. The ACO is designed to give doctors and hospitals incentives to become accountable for a population of patients and to re-design processes that provide for coordinated care, high quality and efficient service delivery. Personal behavior and social and environmental factors have great impact on overall health. ACOs which are made up of doctor and hospital organizations must look to coordinate and integrate with other types of providers in order to impact overall population health. This is difficult for a number of reasons including sharing financial incentives, communicating and sharing patient health information and overcoming the cultural managerial aspects of different organizations. ACO leaders describe how they have integrated with other providers and whether the results show an improvement for a population of patients served by their organization. This research includes a review of the literature concerning how ACOs are achieving integration with other providers and the results of the integration. The result is recommendations on the best practices for achieving provider integration based on evidence of improved patient health.