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The footprint of accountable care organizations (ACO) continues to change. At the start of 2018, there are approximately 1,000 ACOs covering 32.7 million consumers—approximately 11% of the U.S. insured population (294.6 million)—under 1,477 different contracts (see After A Slow 2017, ACOs Grow & Expand Their Contracts In 2018).
The coverage varies by payer. According to Leavitt Partners, about half of the 32.7 million consumers are enrolled in commercial ACOs—roughly 11% of the 186 million people enrolled in commercial insurance. As of 2018, there are eleven states with Medicaid ACO models enrolling 3.8 million individuals and representing 6.2% of total enrollment in 2018 (see The 2018 OPEN MINDS Medicaid ACO Trend Update). Finally there were 612 Medicare ACOs with more than 10.5 million beneficiaries enrolled in them, representing 17.5% of the Medicare population (see Medicare Shared Savings Program Fast Facts).
One issue for specialty provider organizations with ACOs is their “ownership.” Leavitt Partners estimates that about 65%+ ACOs are physician group-led and 25%+ are hospital group-led (see The 2017 ACO Survey: What Do Current Trends Tell Us About The Future Of Accountable Care? and ACOs & Hospitals – The Changing Landscape). But there is wide variation in who is participating in ACOs…