Accountable care organizations are often discussed and promoted as driven by physicians, hospitals, and other health care providers. Yet a team of researchers from The Dartmouth Institute for Health Policy and Clinical Practice recently found that 37 percent of ACOs had a consulting management partner, and two-thirds of these ACOs reported that the partner shared in the financial risks or rewards.
Despite an uncertain political climate and mixed results when it comes to achieving cost savings, the number of ACOs in the United States is steadily increasing, with over 32 million people now receiving their care through an ACO.
In the new study, the researchers used data from the National Survey of Accountable Care Organizations to examine the prevalence of non-provider management partner involvement in ACOs, the services these partners provide, and the structure of ACOs that have such partners.
They found that among ACOs with partners, 94 percent had data services provided by the partner, 87 percent received administrative services, 68 percent received educational services and 66 percent received care coordination. Half of these ACOs received all four of these services from their partner.
Meanwhile, ACOs with and without partners, were similar in performance, cost and quality. Significantly fewer ACOs without a management partner included a hospital (46 versus 74 percent) or were an integrated delivery system (36 versus 57 percent).
ACOs with a partner were also more likely to be composed of only physician groups (45 versus 18 percent) and have a higher proportion of primary care physicians. They were also less likely to offer specialty care or a number of other services, such as rehabilitation or home health.
The findings suggest that management partners are perhaps supplying smaller and physician-run organizations with necessary services or expertise, and that in many of these cases, the management partners are providing financing and acting as "ACO-enablers" by engaging physicians in ACO activity who otherwise would not be participating in them.