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What can we learn from the US experiences on Accountable Care Organizations? Reflections from Germany, the UK, France and Australia.


Alexander Pimperl ,

OptiMedis AG, DE
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Oliver Groene,

OptiMedis AG; Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom, DE
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Julien Mousquès,

IRDES, Paris, FR
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David Peiris,

The George Institute, AU
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Helmut Hildebrandt

OptiMedis AG; Gesundes Kinzigtal GmbH; Gesundheit für Billstedt/Horn UG, DE
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Background: Health care systems worldwide are aiming to achieve the ‘Triple Aim’: improving population health, patient experience and cost efficiency. The Institute of Healthcare Improvement highlights that a key enabler of the Triple Aim is an ‘integrator’, who organizes a close collaboration between all actors, such as care providers, professionals or community institutions. The U.S. has introduced a range of reforms as part of the 2010 Affordable Care Act (ACA). Specific to delivery system reform the ACA provided provisions for the Centers for Medicare and Medicaid Services (CMS) to create a national voluntary program to establish Accountable Care Organizations (ACOs). These organizations are intended to fulfil this ‘integrator’ function and play a central, facilitating role in moving providers and systems towards the Triple Aim. CMS defines ACOs as “[…] groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to the Medicare patients they serve […] When an ACO succeeds in both delivering high-quality care and spending health care dollars more wisely, it will share in the savings it achieves for the Medicare program.” Since their introduction in 2010, ACOs have rapidly proliferated. In just six years there are now over 800 public and private ACOs, covering around 28 million people. With new Medicare reforms coming into effect soon, the ACO sector may cover over 100 million people in the next five years. Many other OECD countries are now also introducing integrated, accountable care initiatives to tackle historic institutional and financial fragmentation. These initiatives have moved up the political agenda in these countries and there may be important lessons from the US ACO experience that could inform policy in this area.

Aims: This session brings together contributions from researchers and managers from four countries, Germany, the UK, France and Australia, who have been conducting in-depth analyses of the design, implementation and policy context of ACOs. They will discuss in their presentations the lessons learned from US ACO models and strategies being undertaken in their home countries that align with these models. Implications of their findings for the US and the four home countries will be elaborated. This session is aimed to help policy decision makers and health care managers to better understand these key issues.

Target Audience: Policy makers, researchers and other healthcare professionals interested in implementing Accountable Care models

Leadership from Accountable Care Organizations or population-based integrated care models - CEO, CFO, COO, CMO, Quality Improvement Leader, IT leader etc.

How to Cite: Pimperl A, Groene O, Mousquès J, Peiris D, Hildebrandt H. What can we learn from the US experiences on Accountable Care Organizations? Reflections from Germany, the UK, France and Australia.. International Journal of Integrated Care. 2017;17(5):A331. DOI:
Published on 17 Oct 2017.


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