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The Council of Accountable Physician Practices (CAPP) engaged the Institute for Accountable Care (IAC) to review recent literature to assess the current state of research on the characteristics and performance of accountable care organizations (ACOs) and accountable physician groups. CAPP has promoted five elements as essential to accountable care: coordinated care, outcomes-based payment, health information technology, physician leadership and quality improvement. This review focuses primarily on the first two elements.
Much of the recent literature on accountable care has focused on ACOs. This review defines accountable care more broadly than ACOs and considers the performance of organized physician groups, integrated health systems and Medicare Advantage programs. We focus on studies of programs that aim to improve outcomes for populations and with payment models tied to a global budget target. More focused initiatives such as episode-based payments, primary-care medical home (PCMH) and pay-for-performance programs are not reviewed here. We supplement some findings from the literature with our own observations based on publicly available data on Medicare accountable care programs. The review is organized into six sections….