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Accountable Care Organizations: Avoiding Pitfalls of the Past

As ACOs become the new thing through health reform, read stories from the trenches by leaders who rode out waves of consolidation in the 1980s and '90s. Most of them did not succeed.

This interview-based report offers insights from health care leaders who experienced the waves of consolidation in the 1980s and 1990s, most of which did not succeed. Although there are differing perspectives among the many leaders interviewed, what emerges from their recollections is a picture of organizations that pushed aggressively into consolidation without:

  • A true understanding of financial risk
  • Aligned financial and strategic incentives
  • Infrastructure necessary to support integrated delivery
  • Effective joint governance
  • A coherent vision or consensus about the ultimate objectives of consolidation

The report focuses on how the creation of accountable care organizations (ACOs), especially physician-to-hospital unions, can be more successful than the earlier efforts through intensive planning and preparation with all partners.

The complete report is available as a Document Download.

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