Tracking, Classification, and Assessment of Accountable Care Organizations: Phase II

Project Overview

Initiatives stemming from the Patient Protection and Affordable Care Act (ACA) and the Centers for Medicare and Medicaid Services (CMS) spurred rapid growth in the formation of accountable care organizations (ACOs) —health care models that aim to improve health care outcomes while reducing care expenditures, potentially receiving a share of the resulting savings if certain goals are met.

As part of the ongoing evolution of health care reform, the number of ACOs and their characteristics has changed rapidly. Insight conducted a 2-phase research study for Optum Labs that sought to track, classify, and assess the characteristics of ACOs, both public and private, across the United States.

This study sought to answer 4 primary research questions:

  1. Where are ACOs developing, and how have they evolved over time?
  2. What are the stages of development of ACO formation?
  3. How do market factors facilitate or impede the decision to form an ACO and its subsequent development?
  4. Which U.S. health care markets are optimal for ACO development?

In Phase II of its ACO tracking research, Insight researchers conducted a comprehensive analysis of the underlying market and risk factors that may affect a health care organization’s decision to establish an ACO. This research provided an analysis of different health care marketplaces and the variables that may influence them.

The results of this analysis will guide the development of theories regarding ACO formation in relation to market structure and risk and assist with the selection of appropriate locations in which to examine and refine these theories.

Core Activities

Database Development; Environmental Scan and Qualitative Data Collection From ACO Representatives; Data Collection and Management; Qualitative and Quantitative Analysis; Report and Presentation Development


  • A comprehensive, up-to-date inventory of ACOs and their descriptive characteristics
  • Report of relevant literature entitled “Marketplace Research of Accountable Care Organizations: Decision Factors for ACO Formation” (August 2013)
  • Presentation at the 2014 Academy Health Annual Research Meeting entitled “Market Characteristics That Support ACO Growth”