A new report released by Leavitt Partners, a healthcare intelligence firm, has identified six types of ACOs based on their organizational structure, ownership and patient care focus.
In 2013, Leavitt Partners began the ACO taxonomy project. The project was started to classify the types of ACOs and to identify opportunities for the varying types.
"ACOs are like unicorns, everyone has heard of them, but no one has seen one," says Mr. Muhlestein. To make ACOs more identifiable, Leavitt Partners wanted to use the taxonomy project to develop classifications for ACOs that are similarly structured and have similar opportunities to provide patient care in the same format, he adds.
The researchers used information from more than 40 surveys and more than 100 interviews with ACO leaders as well as a database of 627 ACOs to analyze characteristics of ACOs and develop the classifications.
The surveys focused more on the structural components of the organizations such as the services they provide and how they are provided. "The interviews were really more free flowing and unstructured," says Paul Gardner, senior analyst at Leavitt Partners and one of the authors of the report. "The surveys helped us develop the classification types, and the interviews provided information about the organizations in each category," he adds.
The Leavitt Partners report, titled "A Taxonomy of Accountable Care Organizations: Different Approaches to Achieve the Triple Aim," identifies the following six types of ACOs:
1. Full Spectrum Integrated. These ACOs directly provide all aspects of healthcare to their patients. ACOs in this classification are often dominated by a large integrated delivery network.
2. Independent Physician Group. These ACOs have a single physician group owner and do not contract with other providers to offer additional services.
3. Physician Group
4. Expanded Physician Group. These ACOs only directly provide outpatient services, but will contract with other providers to offer hospital or subspecialty services.
5.
6. Hospital
Although the ACOs in each group have many commonalities, these types are not definitive. "There is variation still within each of the types and unique challenges each of the organizations face," says Mr. Gardner.
ACOs can benefit from the classification of group types because many ACOs have a lot of good ideas, but they do not know what is going to work. The classifications will allow ACOs to identify the failures and success of like organizations. "Now organizations won't have to reinvent the wheel every time a new ACO comes along," says Mr. Muhlestein
The information and group classifications will also help vendors. "Vendors are trying to sell the same products to all ACOs, and the same products don't work for all ACO," says Mr. Muhlestein. The vendor community wants to know what the needs are for the different types of ACOs so they can meet those needs, and this information will help them do that.
Additionally, the ACO group type information will assist policymakers. "Knowledge about the needs of each type of ACO will help policymakers to customize guidelines to enable the success of different types of ACOs," says Mr. Gardner. For example, certain risk bearing programs may not work with certain ACO types and the groups may require different support tools, he says.
Developing the ACO group types was a huge stride, but "there is still a lot of work to be done," says Mr. Muhlestein. There needs to be a roadmap to success for each of the ACO types, and moving forward, figuring out those roadmaps is a goal of Leavitt Partners and other researchers.
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