The number of active accountable care organizations across the nation increased by 94 over the past year to 838 as of the end of January, according to a recent report by Leavitt Partners and the Accountable Care Learning Collaborative published in Health Affairs.
ACO growth has varied across the country, with accountable care failing to take hold in some regions.
With between 28 and 69 ACOs each, California, Florida, Illinois, Massachusetts, New York, Pennsylvania and Texas are the states with the most ACOs, according to the report.
The states with the fewest ACOs — Alaska, Idaho, Montana, North Dakota, South Dakota, Vermont and Wyoming — each have between two and three ACOs.
Nationally, 8.9 percent of the population is covered by ACOs. The states with the highest ACO penetration — the percentage of lives in a market that are covered by an ACO contract — varies from those with the most ACOs.
With greater than 20 percent of residents covered by an ACO contract, Illinois, Iowa, Maine, Massachusetts, Michigan, Minnesota, New Hampshire, New Jersey, Ohio, Oregon, Utah, Vermont and Wisconsin, are the states with the highest ACO penetration.
"High penetration may be driven by competition among multiple providers within a market who are all adopting accountable care contracts, or it can be driven by a single ACO run by a dominant provider that is able to take risk for a large portion of the population," according to the report.
In states with the lowest ACO penetration — Alabama, Mississippi and West Virginia — between zero and 3 percent of residents are covered by an ACO contract.
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