David B. Muhlestein, PhD, JD

In analyzing 2025 Transparency in Coverage (TIC) files from national insurers, the authors found vast payer-level differences; overall, physician/outpatient data were more complete, and hospital inpatient data were less complete.

Hospital accountable care organization (ACO) participation did not impact emergency department admission rates, length of stay, or costs, suggesting limited effectiveness in reducing spending for unplanned admissions and challenging hospital-led ACO cost-saving strategies.

Accountable care organization (ACO) participation was associated with an increase in hospitals’ mean market share and with additional market share gains in more concentrated markets.

As accountable care organizations’ (ACOs) maturity increased, hospitals participating in CMS ACOs were making progress toward enhanced performance but required more time to improve cost and quality outcomes.

The US should consider reducing or eliminating employer-sponsored insurance. Here are some ways to do it efficiently.

This study compared beneficiary characteristics and Medicare per capita expenditures among seriously ill Medicare accountable care organization (ACO) populations defined using prospective and retrospective claims-based attribution methods.

Since 2015, the majority of new accountable care organizations (ACOs) have been led by physician groups rather than hospital systems. This shift requires policies that address the characteristic strengths and weaknesses of physician-led ACOs.

From 2013 to 2016, Medicare Shared Savings Program accountable care organizations (ACOs) improved quality. Continued infrastructure development funding, better relationships with postacute care facilities, and shared learnings among diverse ACOs would maximize quality improvement.

From 2013 to 2016, successful Medicare Shared Savings Program accountable care organizations reduced spending by shifting expenditures from the inpatient and postacute care setting to the physician office setting.

Analyzes whether hospital participation in accountable care organizations is associated with a hospital’s quality and cost improvement outcomes in other Medicare value-based payment programs.