ACOs already a 'substantial' force, care rises to 1 in 10 Americans, experts say

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The proliferation of accountable care organizations and the patients they serve has reached up to 31 million Americans, according to a report from industry consulting firm Oliver Wyman. In “The ACO Surprise,” the group suggests that ACOs have sneaked up on the market and built a broader base than many thought.

The data collected by the management consulting firm showed that approximately 2.4 million Medicare beneficiaries received care via different Medicare ACO programs run by the Centers for Medicare & Medicaid Services. Fifteen million non-Medicare patients received care at the Medicare ACOs; and 8 million to14 million people are part of ACOs that are operated by large national and regional insurers for their non-Medicare populations.

Research showed that up to 45% of the population lives in a primary care service area (PCSA) served by at least one ACO, and 17% live in a PCSA that is served by two.

The groups are beginning to change the landscape of American healthcare, experts say.

“In a competitive market, when an ACO shows up, other competitors feel like they need to become ACOs as well,” said report co-author Richard Weil. “Patients are going to be attributed to primary care physicians and primary care physicians have to chose one, and only one, ACO – they can't be a part of more than one ACO.”

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