Evaluation of the Accountable Care Organization (ACO) Investment Model (AIM)

Project Overview

This project focuses on evaluating the Accountable Care Organization (ACO) Investment Model (AIM) to assess whether infrastructure funding provided to AIM ACOs results in increased ACO participation in the Medicare Shared Savings Program (MSSP), sustained ACO participation in those programs that were previously MSSPs, and increased willingness by ACOs to accept greater financial risk. This evaluation will also measure the AIM’s effect on cost and quality and determine whether the model leads to better care, healthier people, and smarter spending for Medicare and its beneficiaries. Insight is supporting Abt Associates on this evaluation.

For this evaluation, Insight, is leading an analysis of health care markets, both those that are conducive to ACO success and those that face greater challenges to implementing and achieving cost- and quality-related goals. As part of this market analysis, Insight is examining the alignment of AIM ACOs with these markets. The analysis will provide a rich source of market-level characteristics to support the selection of a comparison group of non-AIM MSSP ACOs for this study.

Insight is also collecting qualitative data with ACO leaders through interviews and site visits to determine program implementation, effectiveness, participation, and risk taking, as well as impacts of care, health, and costs.

For this project, Insight:

  • Conducts environmental scans on ACO market factors.
  • Conducts a quantitative analysis of marketplace characteristics in AIM ACO markets and comparison markets.
  • Leads interviews with ACO leaders.
  • Analyzes and summarizes qualitative findings.
  • Creates reports for the Center for Medicare & Medicaid Innovation.

Core Activities

Data Extraction; Primary and Secondary Data Analysis; Marketplace Analysis; Document Reviews; Environmental Scans; Evaluation Design and Implementation Evaluation; In-Depth Interviews; Literature Reviews; Policy Analysis and Assessment; Program Evaluation; Site Visits


  • Semiannual reports (expected July 2016, 2017, 2018; January 2019)
  • Final report (expected June 2019)
  • Analytic files (expected July 2019)