The Accountable Care Paradigm: More than Just Managed Care 2.0

Accountable care organizations have become an emphasis in health policy circles, but some feel they represent the return of 1990s managed care. Accountable care, however, represents a fundamental rethinking of how care is delivered rather than a narrow focus on costs. By studying the efforts of over 400 organizations experimenting with accountable care, we have developed a paradigm that defines the movement in terms of structural requirements, core processes and expected outcomes. Organizations that adopt accountable care must bear financial risk for a defined population, oversee the clinical component of care and provide measured outcomes of cost and quality.