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Do the most efficient accountable care organizations earn shared savings?


  • Palazzolo, Jennifer R.
  • Ozcan, Yasar A.


Accountable care organizations (ACOs) are increasing in number and coverage of beneficiaries. In 2016, over 400 ACOs participated in the CMS initiative with contracts covering an estimated 8 million Medicare beneficiaries. However, in 2014, less than one-third of ACOs achieved requirements to earn shared savings. The aim of the study was to determine whether the most technically efficient ACOs realized earned savings. A contingency theory framework helps explain how variation in two factors, use of electronic health records (EHRs) by primary care providers and inclusion of specialists, may affect the operational performance of ACOs.

Suggested Citation

  • Palazzolo, Jennifer R. & Ozcan, Yasar A., 2018. "Do the most efficient accountable care organizations earn shared savings?," Socio-Economic Planning Sciences, Elsevier, vol. 63(C), pages 12-17.
  • Handle: RePEc:eee:soceps:v:63:y:2018:i:c:p:12-17
    DOI: 10.1016/j.seps.2017.05.001

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    References listed on IDEAS

    1. O'Neill, Liam & Rauner, Marion & Heidenberger, Kurt & Kraus, Markus, 2008. "A cross-national comparison and taxonomy of DEA-based hospital efficiency studies," Socio-Economic Planning Sciences, Elsevier, vol. 42(3), pages 158-189, September.
    2. Given, Ruth S., 1996. "Economies of scale and scope as an explanation of merger and output diversification activities in the health maintenance organization industry," Journal of Health Economics, Elsevier, vol. 15(6), pages 685-713, December.
    3. Barnes, Andrew J. & Unruh, Lynn & Chukmaitov, Askar & van Ginneken, Ewout, 2014. "Accountable care organizations in the USA: Types, developments and challenges," Health Policy, Elsevier, vol. 118(1), pages 1-7.
    4. R. D. Banker & A. Charnes & W. W. Cooper, 1984. "Some Models for Estimating Technical and Scale Inefficiencies in Data Envelopment Analysis," Management Science, INFORMS, vol. 30(9), pages 1078-1092, September.
    5. Charnes, A. & Cooper, W. W. & Rhodes, E., 1978. "Measuring the efficiency of decision making units," European Journal of Operational Research, Elsevier, vol. 2(6), pages 429-444, November.
    6. Robert Rosenman & Kris Siddharthan & Melissa Ahern, 1997. "Output Efficiency of Health Maintenance Organizations in Florida," Health Economics, John Wiley & Sons, Ltd., vol. 6(3), pages 295-302, May.
    7. Yasar Ozcan, 1998. "Physician benchmarking: measuring variation in practice behavior in treatment of otitis media," Health Care Management Science, Springer, vol. 1(1), pages 5-17, September.
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