Journal of General Internal Medicine

, Volume 33, Issue 10, pp 1601–1603 | Cite as

Engagement of Accountable Care Organizations in Acute Care Redesign: Results of a National Survey

  • Michelle P. LinEmail author
  • David Muhlestein
  • Brendan G. Carr
  • Lynne D. Richardson
  • Jennifer L. Wiler
  • Jeremiah D. Schuur
Concise Research Reports


Accountable Care Organizations (ACOs) are integrated provider groups aiming to improve health care value for a population. Hospitalizations account for ~ 32% of US health care expenditures, and ED visits account for up to 6%; therefore, one strategy to improve value is to manage the acute care needs of the population in lower cost settings.1 To date, most cost-reduction efforts have focused on improving chronic disease management, for example, through medication management and decreasing readmissions.2

We aim to describe how ACOs are prioritizing cost-reduction strategies related to acute unscheduled care using responses from a national survey of ACOs.


We surveyed all known ACOs in the USA from January 2017 to April 2017; these included participants in Medicare, commercial, and Medicaid insurance programs. We asked ACO leaders to prioritize six strategies to address acute unscheduled care (including ED and urgent care) including 4 types of care redesign, and 2...


health services accountable care healthcare Reform 



We would like to acknowledge Kerstin Edwards, MPA, Research Manager at Leavitt Partners and Teresa Litton, MPH, Senior Policy Advisor at the National Association of ACOs, for their contributions to this work.

Funding Information

This project was funded by a Health Policy Research grant from the Emergency Medicine Foundation (Schuur, Lin). An abstract was presented at ACEP Scientific Assembly, Washington, DC, October 30, 2017.

Compliance with Ethical Standards

Conflict of Interest

Mr. Muhlestein is an employee of the for-profit Leavitt Partners, LLC. Dr. Carr serves as Director of the Emergency Care Coordination Center in the US Department of Health and Human Services; the views expressed here do not necessarily represent those of the government. He has also received payment for legal consulting from BGC. Dr. Wiler has received royalty payments from AgileMD and CareThrough. Dr. Schuur has received compensation for his work on the Scientific Advisory Board for UnitedHealth. All remaining authors declare that they do not have a conflict of interest.


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Copyright information

© Society of General Internal Medicine 2018

Authors and Affiliations

  • Michelle P. Lin
    • 1
    Email author
  • David Muhlestein
    • 2
  • Brendan G. Carr
    • 3
  • Lynne D. Richardson
    • 1
  • Jennifer L. Wiler
    • 4
  • Jeremiah D. Schuur
    • 5
  1. 1.Department of Emergency MedicineIcahn School of Medicine at Mount SinaiNew YorkUSA
  2. 2.Leavitt PartnersSalt Lake CityUSA
  3. 3.Sidney Kimmel Medical CollegeThomas Jefferson UniversityPhiladelphiaUSA
  4. 4.University of Colorado School of MedicineDenverUSA
  5. 5.Brigham and Women’s Hospital and Harvard Medical SchoolBostonUSA

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