Detailed description of background, features, requirements, risks and strategy for ACO development.

1. ACOs: Core Features and Implications for Care Delivery Charles DeShazer, MD

3. What is an Accountable Care Organization (ACO)?

6. Why is ACO formation being supported by the government?

9. Exhibit 1. International Comparison of Spending on Health, 1980–2007 Note: $US PPP = purchasing power parity. Source: Organization for Economic Cooperation and Development, OECD Health Data, 2009 (Paris: OECD, Nov. 2009). $7,290 $2,454 16% 8% Average spending on health per capita ($US PPP) Total expenditures on health as percent of GDP

10. Threefold variation in per capita spending Source: Peter Orszag, N Engl J Med, 2007

11. The lack of a relationship between quality and Medicare spending, by state, 2004 Composite Measure of Quality of Care Source: Data from AHRQ and CMS.

14. How are ACOs different in design and operation?

18. Reimbursement Models and Delivery Structure Source: ACO Toolkit. Brookings-Dartmouth Collaborative 2011

23. ACO and Payment Continuum Source: ACO Toolkit. Brookings-Dartmouth Collaborative 2011

28. What are the critical success factors for ACOs?

31. How should providers evolve to or participate in ACOs?