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Takeaway Points
We assessed trends in market share over time among short-term acute care hospitals participating in accountable care organizations (ACOs) and non-ACO participants.
- ACO participation was associated with an increase in mean market share.
- ACO participation was associated with additional market share gains in more (vs less) concentrated markets.
- More importantly, baseline (2011) market share was the most important predictor of market share growth.
Accountable care organizations (ACOs) are groups of doctors, hospitals, and other health care providers that accept financial risk for the entire continuum of patient care. ACOs seek to promote care coordination to lower the cost of care while improving quality. From the ACO contract perspective, including a hospital may have various benefits, such as maintaining a referral network of hospital care and reducing costs (eg, from unnecessary hospitalizations). Prior studies have found that hospitals participating in ACOs varied in characteristics compared with nonparticipants. Early program research found that ACO participants were likely to be large, part of a health care system, teaching hospitals, not for profit, and located in more competitive and urban areas with higher income per capita and to have prior experience with risk-based payments and care management programs