Accountable care organizations are already beginning to change the landscape of American healthcare, veteran observers say.

ACOs currently reached as many as 31 million Americans, according to a report from consulting firm Oliver Wyman. In “The ACO Surprise,” the group suggests that a combination of privately and government run ACOs have built a broader base than many may have thought.

“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.

Long-term care providers have been keen to pair up with quality acute-care partners. The latter are seen as the gate-keepers to the funds.

Currently, 153 ACOs contract with Medicare. That number might double in January, said Richard Gilfillan, the head of the Center for Medicare & Medicaid Innovation.

When certain quality marks are reached by an ACO, involved providers will share any savings achieved. 

About $10 billion is available to the Innovation Center through fiscal 2019 due to funding under healthcare reform.