HEC Forum

, Volume 29, Issue 4, pp 359–365 | Cite as

The Case for Enrolling High-Cost Patients in an ACO

  • Abraham Graber
  • Shane Carter
  • Asha Bhandary
  • Matthew Rizzo


Though accountable care organizations (ACOs) are increasingly important to American healthcare, ethical inquiry into ACOs remains in its nascent stages. Several articles have raised the concern that ACOs have an incentive to avoid enrolling high-cost patients and, thereby, have an incentive to deny care to those who need it the most. This concern is borne out by the reports of consultants working with newly formed ACOs. This paper argues that, contra initial appearances, there is no financial incentive for ACOs to avoid enrolling high-cost patients.


Accountable care organizations Bioethics Medical ethics Patient Protection and Affordable Care Act High-cost patients Healthcare expenditures 


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Copyright information

© Springer Science+Business Media B.V. 2017

Authors and Affiliations

  1. 1.Department of Philosophy and ClassicsUniversity of Texas at San AntonioSan AntonioUSA
  2. 2.Carter HealthCare SolutionsSan AntonioUSA
  3. 3.Department of PhilosophyUniversity of IowaIowa CityUSA
  4. 4.Department of Neurological SciencesUniversity of Nebraska Medical CenterOmahaUSA

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